Rachel Siewert (WA, Australian Greens) Share this | Hansard source

It is with a great deal of sadness that I contribute to this debate. Of course, I stand with my colleague Senator Di Natale to oppose the abolition of the Australian National Preventive Health Agency. I was the Greens health spokesperson when we negotiated the establishment of this agency. We strongly believe that investment in preventive health not only saves lives but also decreases healthcare costs into the future. At that time, I opened my contribution to the debate by saying:

The Greens believe that the real challenge for our health system, now and into the future, is managing illness in a way that keeps people out of hospital and well. We believe the evidence is overwhelming that our health policies should focus on keeping people well, preventing illness and better managing illness in the community. We strongly believe in preventative health measures and believe that we should be investing in preventative health measures.

I went on to say that the Greens believe that strong leadership is required if preventative health activities are to get the attention and funding that they need. That is as true today as it was when I said that in my contribution to this debate. Nothing has changed other than, I would suggest, the fact that we now have more evidence, particularly for Aboriginal and Torres Strait Islander communities, of the importance of preventative health. I will go into those specific issues around Aboriginal and Torres Strait Islander health later in my contribution.

We have seen no evidence at all to suggest that this is not the best way to address issues around preventative health. Investment in preventative health saves money into the future, it saves lives and ensures better-quality lives. Our investment in public health is woeful compared to spending on other health issues. You cannot say the evidence is there to abolish this agency. I agree with my colleague Senator Di Natale when he said that this is ideologically driven. Yes, the government's ideologically driven changes are the same as their punitive welfare income support changes which, hopefully, will be rejected by this place when the legislation comes before us. They are ideologically driven. There is no evidence to suggest it works and there is no evidence to suggest that abolishing this agency will help address preventative health. The reason this agency was set up is that we dealt so appalling with preventative health agencies. We spend a small amount on preventative health and that investment is a wise investment.

I would suggest that the government's approach to this matter is more in line with the heavy lobbying from industry that actually lobbied against this agency in the first place, with their gutless approaches to investment, their attempts to decrease the sale of alcohol, trying to put in place effective measures that address alcohol abuse and the accessibility of junk food. The fact that it is now cheaper to feed your family on cheap, energy-dense, poor-quality junk food than it is to actually feed your family if you are on a low income on nutritious, healthy food is also part of their agenda.

During the debate on this particular agency, that big industry were all over the corridors of this place, lobbing against putting in place effective preventative health measures and an effective preventative health agency. I would suggest, again, it is a combination of ideology, driven by industry to try to get rid of effective preventative health measures.

One area that I particularly want to contribute to in this debate is the fact that we are still, appallingly, behind in addressing the gap in life expectancy for Aboriginal and Torres Strait Islander peoples. Just this month, two surveys highlight yet again how important it is that we take preventative health seriously in this country. Just on 10 September, the Australian Aboriginal and Torres Strait Islander Health Survey: Biomedical Results, 2012-13 was published. This survey is the largest biomedical survey ever conducted for Aboriginal and Torres Strait Islander peoples. It undertook a survey of 3,300 Aboriginal and Torres Strait Islander adults from across Australia, who voluntarily took part in this survey and who were tested for a range of chronic disease and nutrient biomarkers. The results showed that, on a national level, one in 10, 11.1 per cent, of Aboriginal and Torres Strait Islander adults had diabetes. A further 4.7 per cent were at high risk of diabetes according to their blood test results. Two in three, 65.3 per cent, had at least one risk factor for cardiovascular disease—that is, they were taking cholesterol-lowering medication or had one or more of high total cholesterol or high triglycerides. Nearly one in five, 17.9 per cent, had signs of chronic kidney disease and we know the relationship between diabetes and chronic kidney disease.

It also revealed that, for Aboriginal and Torres Strait Islander adults, around half, 53.1 per cent, with diabetes also had signs of chronic kidney disease. Two in five, or 38.9 per cent, with diagnosed diabetes were effectively managing their disease. They had a HbA1c test result of less than seven per cent. A quarter had high cholesterol but only one in 10 of this group were aware that they had it. These results, when compared with the national average across the nation, were worse in remote areas. Very distressingly, when you compare the non-Indigenous population with these results you see the average Aboriginal and Torres Strait Islander peoples are more than three times as likely to have diabetes, twice as likely to have signs of chronic kidney disease, nearly twice as likely to have high triglycerides and more likely to have more than one chronic condition, for example, having both diabetes and kidney disease. These are appalling results and they are for 2013.

On 5 September, the Australian Institute of Health and Welfare released some results for closing the gap in life expectancy. They showed there had been slight improvements in Indigenous life expectancy over recent years. But, unfortunately, they were too slow but also there is still a gap, whereby the life expectancy for an Aboriginal and Torres Strait Islander is about 10 years lower than the general population.

Their report Mortality and Life Expectancy of Indigenous Australians 2008-12, provides an overview of some of the trends and patterns in life expectancy for Aboriginal and Torres Strait Islander people. Importantly for this debate, in terms of the issues around life expectancy most significant among them was chronic diseases, with four groups of chronic conditions accounting for over two-thirds of the gap in mortality-circulatory diseases, 24 per cent of the gap; endocrine, metabolic and nutritional disorders, 21 per cent; cancer, 12 per cent; and respiratory disorders and diseases, 12 per cent. Circulatory diseases were the leading cause of death among Indigenous Australians between 2008 and 2012, representing 26 per cent of Indigenous deaths, followed by cancer at 20 per cent and injury. Two-thirds of Indigenous deaths occurred before the age of 65, compared to 19 per cent for non-Indigenous Australians, who died before the age of 65.

They said that while there were some improvements in the general population for cancer, the death rates from cancer actually rose between that time for Aboriginal and Torres Strait Islander people from 212 per 100,000 people to 227 per 100,000 people. That was from 2001 to 2012. There is a widening gap in deaths from cancer in Aboriginal populations. And what is this government doing? Not only is it abolishing this agency that deals with the very issues that would deal with these particular diseases—