Katie Allen (Higgins, Liberal Party) Share this | Link to this | Hansard source

It's not often that you come to this place and one of the first inquiries that you sit on regards the expertise in your former life. So it is with a great sense of pride that I support the report that was recently handed down on the inquiry into allergies and anaphylaxis, Walking the allergy tightrope. I've spent a lot of my professional career dealing with families and children with food allergies. The reason that I did this is that, as a paediatric gastroenterologist, I became exposed to people who were complaining about things that were affecting their life and they didn't know why. I dedicated my professional career to trying to understand this new concern: food allergy. As a medical student and as a medical professional, we were not trained in allergy, so there is a whole cohort of doctors who have had to be reverse trained in order to understand the issues of allergy. I would like to make the comment that the report that was handed down just this week is of immense importance because the committee members who sat on the committee came across information that many doctors, who are formally trained, have not come across. I would say that the committee are now experts in allergy, which is wonderful for this place.

Food allergy is one of the conditions that is terribly frightening for families and the person or child affected. When someone is exposed to something that could be completely safe for 99 per cent of the population but could effectively kill them if they were to eat it is terribly frightening. But, more than that, there are many families with food allergies who seek help from doctors and are not offered the right advice, the right management or the right treatment. I would like to congratulate the allergy community for the work they have done over the last 10 to 20 years to increase awareness about this particular group of conditions and to bring light to this area that has so needed exposure to information.

As a paediatric allergist, the most common question that I was asked is: is food allergy on the rise? Also: if it is on the rise, why is it on the rise? People just cannot understand how something as innocuous as a peanut can literally kill somebody. I spent a lot of my medical research time trying to understand why food allergy was on the rise. I'm pleased to say that the food allergy community, both here in Australia and overseas, has delivered information for a number of reasons why we think food allergy is on the rise. We are at the point where we're able to make some public health recommendations to help turn back the tide of food allergy. This is a very exciting time in medical research and, indeed, for healthcare practitioners because they have an ability to make a real difference. I often used to say to people, 'Cancer, infectious diseases, Alzheimer's—you name it: these medical conditions have been around for as long as mankind, but food allergy in particular and allergy diseases in general have only occurred more recently.' This is a concern of the modern era. This is a particularly interesting era for medical researchers to try and understand why something like this is occurring. The possibility that, as this has occurred only in the last number of decades, we could potentially completely eliminate it is incredibly tantalising.

I really recommend this report because it focuses on recommendations on how to move this area forward for the benefit of families with food allergy and other allergy, for children and adults who are suffering with allergic disease. It is amazing that one-third of people in Australia will develop allergies over their lifetime. So many people have problems with hay fever, asthma, food allergy, eczema and anaphylaxis, but unfortunately Australia has the highest rate of food allergy ever reported. Unfortunately, Australia is the food allergy capital of the world. Australia is a country; it's not a capital, but you get my point; we do have incredibly high rates. In fact, 10 per cent of children aged 12 months appear to have food allergy in Melbourne, which has the highest food allergy prevalence in Australia. Over four million people are living with allergies, and this number continues to rise. Of course, the most common food allergy consequence that is most frightening for everyone is anaphylaxis. As someone who themselves has a peanut allergy, I know how frightening it can be to have the most life-threatening condition, anaphylaxis. All that we can do to help save lives and protect lives through prevention of anaphylaxis is a very important outcome indeed.

Last August, in 2019, the Minister for Health, Greg Hunt, referred the inquiry into allergies and anaphylaxis to the Standing Committee on Health, Aged Care and Sport. The inquiry looked into the prevalence, management and treatment of allergies. It was a very thorough inquiry. It received 257 submissions from members of the public, doctors, parents and organisations. I would like to congratulate all of those submitters for their dedicated work. These people took time out of their professional days to either provide a submission to the inquiry or present in person. I'd particularly like to thank Maria Said from Allergy and Anaphylaxis Australia; Jill Smith and Preeti Joshi from the Australasian Society of Clinical Immunology and Allergy; Kirsten Perrett and Jennifer Copland from the Centre for Food and Allergy Research; and Richard Loh and Maria Said from the National Allergy Strategy. Now, Richard has recently retired from the National Allergy Strategy, but it is very important that we acknowledge the important work he has done advocating for a national approach to allergies.

When I travelled internationally as a medical researcher, there was absolutely no doubt that we had some of the highest rates of allergic disease in the world; but, we equally had the best health care with regard to clinical guidelines and the allergy profession working together to protect allergy patients. More importantly, we have a very dedicated multicentre group of people who were interested in trying to work out how to deal with allergies better, and Richard Loh and Maria Said should be congratulated for the work they did in coming up with this National Allergy Strategy. Some ideas that have come forward as recommendations by this committee have been informed by that information.

There were a number of recommendations made after seven hearings. The first was a recommendation that there be a national centre for allergies and anaphylaxis in Australia to continue the work that has already been done and to explain why Australia has the highest rate of allergy in the world.

Recommendation 2 was additional funding into food allergies and anaphylaxis research, in particular funding for clinical research into oral immunotherapy trials. We know that a number of families—in fact, hundreds of families—are travelling to the United States and receiving care for food allergy because they cannot get that care here in Australia, and that care is oral immunotherapy. So people who have peanut allergy or egg allergy or other food allergies are living with these allergies and living with the risk of having anaphylactic events in uncontrolled situations. Some of these families have spent upwards of $35,000 to travel to the US for a cure for their food allergy. These clinical trials at this point in time are still in the research domain here and overseas, so our recommendation is that Australia leads the way by starting oral immunotherapy trials for food allergy here so that we can provide cutting-edge research and clinical trials to families who have food allergy.

The inquiry report, Walking the allergy tightrope, has also recommended we ensure that the Australasian Society of Clinical Immunology and Allergy receive ongoing long-term funding to continue its partnership work with the Department of Health and the National Allergy Strategy to develop minimal standards of allergy training for health professionals, and to continue the good work that these collaborative organisations and institutions have already commenced.

Recommendation 6 recommends that telehealth funding support for doctors and allied health workers is provided so that we can have professional services that give support to allergy patients in rural, regional, and remote Australia. I know, as a paediatric allergist, I had people travelling from all over Victoria and, indeed, from all over Australia—and even from the Asia-Pacific!—to have specialist care for food allergy provided at the centre that I used to work at, the Royal Children's Hospital in Melbourne and the Murdoch Children's Research Institute.

Recommendation 12 recommended that the Therapeutic Goods Administration provide some competitive alternatives for autoinjectors. It was made very clear that there have been issues with the supply chain for autoinjectors. Fortunately, that does not appear to have happened during the recent COVID pandemic, but it has happened previously when there have been supply line issues. It was thought it was important that patients always have access to adrenalin autoinjectors to ensure that they remain safe.

Recommendations 14, 15, 16 and 17 provide that we ensure there's vocational education about food allergies in food service. Now, we do know that schools around Australia have made great headway in legislating to ensure that children in schools are kept safe. In fact, state legislation in Victoria has ensured that Victoria does not take a back seat to safety compared to anywhere in the world, being one of the first states to legislate for food allergy. But we would like to see a more standardised approach for all states to have education in schools, and we'd also like to see consistency in vocational education about food allergies in food service. We'd also like to see consistent food processing, including the use of the vital tick. Now, it is very important that the allergen—I've been told I have 10 minutes, not five minutes.

David Gillespie (Lyne, National Party) Share this | Link to this | Hansard source

You've spoken for 10 minutes.

Katie Allen (Higgins, Liberal Party) Share this | Link to this | Hansard source

I've spoken for 10 minutes? Oh! I would like to conclude by thanking the member for North Sydney, the chair of the committee, and the member for Macarthur, the deputy chair. Thank you, Mr Deputy Speaker Gillespie, for your indulgence. I clearly have a passion for this subject, and I thank the committee for their work.

Tony Zappia (Makin, Australian Labor Party) Share this | Link to this | Hansard source

I say to the member for Higgins that going over time was not a problem for this side of the House, because it is indeed a very important issue and 10 minutes doesn't do the issue justice. Member for Higgins, well done for the contribution you made within that limited time.

I will begin by thanking both the secretariat and my committee colleagues, including the member for North Sydney, who's in the chamber and who chaired the committee's work, for their work in this inquiry. I agree with others who have made it absolutely clear: this was a very significant inquiry, not just because of the work of the committee but also because of the issue at hand. I particularly thank the many people who made submissions, both written and in person, to the committee, especially those people with allergies who fronted up before the committee and told their personal stories and their lived experiences. For me, it was a real eye-opener. It's not that I haven't had some experience with allergies, but it was a real eye-opener to hear about some of the struggles, the social limitations, the financial cost, the stresses and the severe discomfort that many people live with each and every day.

As others have said, some four million Australians around the country live with an allergy. Ten per cent of children and two per cent of adults live with allergies. Those figures themselves are quite startling, and when you put them into perspective you start to understand that you can't go very far without running into someone who has an allergy problem of one kind or another.

For those whose allergies can result in life-threatening anaphylaxis, life, as we were told in the report, must be very much like walking a tight rope or walking through a minefield, particularly as so many of the risks are often beyond the person's control and impossible to detect. I'll use the case of the pesto and peanut issue of earlier this year that was brought to the committee's attention. Again, there were undeclared peanuts in a product—pesto that contained cashews—that was imported from overseas. No-one was to know. Families looked at the label, and, before you knew it, some people had suffered severe reactions to it. That highlights the risks I'm referring to.

Between 1997 and 2013, there were 324 recorded deaths from anaphylaxis in Australia, and, as the report says—and I agree with it—I suspect those rates were underestimated. Quite often, while a death might not have been directly linked to the allergy, it was the allergy that triggered the chain reaction that ultimately caused the death. So, I suspect it was much worse than that.

Australia has one of the highest allergy rates in the world, and that in itself is an interesting phenomenon that I would like to think we would put a lot more research into. Having said that, I accept that Australia is also a world leader in allergy research—but we could do a lot more, and we should. As a country, we're in a position to do more, if the will is there.

I note with concern and interest that, in the past 10 years, hospital admissions for food allergies increased fourfold. Again, that begs the question: why? I don't know why. We can all speculate, and I think the committee tried to come to some conclusions about it, but it's of real concern that it is happening. It's also of real concern—and I can talk about this from experience because it happened in my family—that 10 per cent of infants up to 12 months have an allergic reaction to a food. For a mum to see a little baby suddenly turn red and stop breathing because of an allergic reaction would be a nightmare. I have to say it would be one of the most frightening experiences I can imagine.

I believe we should be focusing on four areas: research; medical education, which the previous speaker spoke about a moment ago—I think it is critical for our GPs and others to be better trained with respect to treatment and diagnosis; public education, so that the broader community, right across the board, understands the risks associated with allergic reactions; and educating the food industry, whether it be food processors or fast-food retailers, both of whom have a critical role to play here. Many have done a terrific job, but it hasn't been enough. That's where most of the risk arises.

I'll conclude with this observation. It really comes down to this, and I have to say that it's an issue that often frustrates me with respect to the work of this committee and others, but particularly this committee, on other matters as well. We spend billions of dollars in this country each year on military equipment and defence projects. When there's a blow-out, not of thousands, not of millions, but of billions, we just accept it: 'That's okay. We can find the money for that. It's not a problem.' We just spent billions of dollars as part of a stimulus package. Again, there was no criticism. The fact is that there was a need, and we found the money, and we're spending it in a way that we would like to think helps the broader community out there. Yet we can't seem to find modest amounts of money that would truly change the lives of people who are suffering each and every day in this country, and I think that that mindset needs to change. The report goes to some of these issues.

Recommendations 3, 4, 5, 6, 7 and 8 all go to the issue of trying to provide a little more comfort to those people who are suffering from allergies in one way or another, whether that is through giving them access to medications which for some bureaucratic reason they cannot access right now but which we know will help them—they should be able to access that medication—or through disability support payments, because, in some cases, where an allergy results in a severe disability for a person they should be entitled to be treated like everyone else who has a disability. Again, I accept that that comes down to a medical diagnosis, but where it is the case—and we had examples of this presented to us—they should be given that type of support. It would make a world of difference if there were carers payments made available to people who are caring for people who could not survive without a carer. I don't believe this country cannot afford to provide support for these things. I think that, when you sum up the total cost of all the things that we would like to see, it would pale into insignificance in terms of the money we spend in other areas. Yet, I doubt the difference made to the lives of people in those other areas would be as important or make as much difference as the expenditure on this issue would.

The people who appeared before the committee or made submissions to the inquiry are, through the voice of the committee, pinning their hopes on this parliament giving them the support that they are literally begging for in some cases. For those reasons, I hope that the minister will embrace the recommendations in this report, because all the recommendations were carefully thought through.

Debate adjourned.