Cory Bernardi (SA, Liberal Party) Share this | Link to this | Hansard source

This week is Men’s Health Week, and I rise to talk about the important issue of men’s health. The focus of this week is preventative health measures for men and encouraging healthy behaviour in men. My interest in this area is longstanding and recently I was the Chair of the Senate Select Committee on Men’s Health, in which you were a participant, Madam Acting Deputy President Troeth. I thank you very much for your contribution and I thank all those who contributed and made one of the 137 submissions received or participated in one of the four hearings held in different states around Australia.

Men’s health is not simply about physical health, and the committee inquiry reflected this. We talked about not only the physical health of men but also the mental health of men, men’s attitudes towards their own health, and social and community attitudes. We looked at the utilisation and the availability of services. Some facts emerged which I would like to put on the record today. Average life expectancy at birth today is nearly five years less for men than it is for women. Male life expectancy declines from around 79 years, in urban areas, to 72 years in very remote areas. More than five men die every hour from conditions that are potentially preventable, including diabetes, high blood pressure, heart disease and prostate cancer. Men are four times more likely than women to commit suicide. In terms of the most common causes of death for men, the alarming statistic is that suicide ranks above melanoma and even land transport accidents. In 2005—the most recent statistics I have—male deaths exceeded female deaths in every single age group except the 85-plus age group, because there are not as many men as women living to 85-plus.

It emerged that men’s health is influenced by a range of factors, which include but are not limited to: risk-taking behaviours, substance abuse, alcohol abuse, family breakdown, socioeconomic status, social attitudes and the availability and utilisation of services. It is an even more alarming statistic when we consider Indigenous men’s health, because Indigenous men—and men living in regional areas—face enormous challenges in this area.

We need to know more about the factors that impact on men’s health before we can hope to address them adequately in an attempt to improve health outcomes for the entire male population. I would like to stress that it is a focus across the male population. It is not just about older men looking after their health because they are grandfathers or they are husbands; it is about young men looking after their health too, because an ounce of prevention—as the phrase goes—is worth a pound of cure.

Women in this country have had the benefit of a longitudinal study into women’s health. It started in 1995. It has made great inroads into treatment of women’s health issues. It is time that a similar longitudinal study was implemented for men, because it would make a similarly significant contribution over the longer term. This has been started, effectively. We could build on a study by Andrology Australia which could be the basis of a longitudinal study. I hope that the government, with the support of the coalition, will support the introduction of such a longitudinal study into men’s health.

There are some other, simpler things that we can also do. One of them is getting more men to doctors and having physical check-ups. From the evidence that was given to the committee, we found that men are not distinctly opposed to going to a doctor—they are prepared to have their health checked and they are prepared to get medical advice—but they really need certain circumstances in which to do it. We found that they do not really like to wait around in a doctor’s waiting room but they are happy to speak to a doctor or get some medical advice in their workplace or in an environment where they feel very comfortable.

One of the suggestions of the committee—and I think it is an excellent one—is that there be a comprehensive annual men’s health check-up. We would like the government to consider a Medicare item for that, although I do not have any costings on it. The simple fact is that there are a number of early warning signs about men’s health. If we can just get men to go through this process, we will pick those up and, once again, the preventative cost will be far, far less than the curative cost. There could be, for example, checks of blood pressure, cholesterol, blood sugar levels and liver function as well as prostate examinations or PSA tests if required.

A significant number of men do have contact with their doctors, but we found that a lot of the contact is not long enough to go through the entire range of procedures or consultations that men sometimes require. Anyone who is in a longstanding relationship with a man will understand that it sometimes takes a little bit of time to draw information out of us. Doctors experience just the same issues, because men sometimes take a while to get around to the point of their visit. This is the sort of thing that we heard, and we need to make this process as flexible and considered as it possibly can be for men.

One of the alarming statistics in Australian men’s health today is the prostate cancer figures. Prostate cancer is the most commonly diagnosed cancer in Australia. It actually accounts for 4.4 per cent of total deaths in men. It is worth noting that breast cancer, another significant cancer, particularly for women, accounts for 4.3 per cent of deaths for women, so they are comparable. Great inroads have been made in regard to research into the causes of breast cancer and also the treatment of breast cancer, but right now the same level of application has probably not been applied to the causes and treatment of prostate cancer. It is estimated that the rate of prostate cancer will rise by over 900 cases a year due in part to our ageing population but also because there is, I guess, earlier diagnosis in many instances. The statistics alone are very alarming and concerning and are reason enough to request further resources for prostate cancer research as well as further treatment and support services.

In the research area there is the Australian Prostate Cancer BioResource, which is the main prostate tissue collection service in Australia. This tissue collection is absolutely vital for ongoing research into prostate cancer. It enables researchers to gain a better understanding of the cancer, thereby paving the way for treatments and a possible cure. But the BioResource, like all medical research, requires significant amounts of funding to do the work that it has been doing over the past years. Certainly I would support the government in identifying and supplying additional funding and continuing funding for this important work.

The other part of prostate cancer is that it was brought to our attention that once it is diagnosed there are any number of treatment options. I would say there are seven main ones. Of the seven treatment options, do nothing is one and have radical prostate surgery is another. They are at different ends of the spectrum. Frankly, men do not get that much advice about which one is the most appropriate or the best one for them. This is part of the research that needs to be done, because prostate cancer is very different. Just last night on television I saw a new treatment using sound which is having some success in treating prostate cancer in England, and I certainly hope that further advances will be made in that regard. By spending a bit of money now on research and potential cures and treatment of prostate cancer, and identifying the most appropriate of the current treatments for men suffering from prostate cancer, we will save lives, and by saving lives we protect our community, we protect our families and we protect our fathers and our husbands, our sons and our grandfathers.

There are a couple of other issues that I will draw to the attention of the Senate in regard to men’s health. They relate specifically to remote and regional areas. Quite often the access to services is not available there. There are sometimes concerns about issues to do with privacy in a small country town with everyone knowing everyone else’s business, so they are very concerned about going to a local doctor with any particular illness because they feel that somehow other people will find out about it. One of the great successes that has taken place is where we have had nurse practitioners or specialist men’s health nurses go out and visit a community and have confidential talks on a regular basis with individuals. Because they are a part of the community—because of the regularity of their visits—but they are not resident within the community, there seems to be an opportunity for men to open up a little bit more and to access a more comprehensive health service, or just to explore some of the issues and feelings that they have which will benefit them and their communities over the long run.

But of course illness is not confined to physical maladies, and mental illness in men is a very significant issue. I mentioned earlier that men are four times more likely to commit suicide than women. It is an alarming statistic and is one that needs to be addressed. There are many organisations doing excellent work in the treatment of mental illnesses, such as depression, which increase the risk of suicide. One of the amazing things that came up is a dark triangle, I would guess, which is depression, alcohol abuse and other substance abuse. What leads to what is the 64 dollar question, quite frankly. If you are depressed, are you more likely to consume significant amounts of alcohol or other drugs; or because you are consuming significant amounts of alcohol or other substances, does that lead to depression? I do not know the answer to that. I am not sure anyone really does and I am not sure it is that important. What is important is that men can identify in other men, in their friends and colleagues, and in themselves that there are some problems starting to develop either in their physical behaviour or in their emotional wellbeing. Importantly, once it is identified they can get some appropriate treatment for it. Over 70 per cent of men with a mental disorder do not access mental health services. They think, ‘It’ll be right, mate,’ and they go through a very informal process. Unfortunately often the process does not work for them and the result is a much higher suicide rate or injury rate for men.

Some of the benefits that are seen are in small, non-bureaucratic, non-government structures like the Men’s Sheds movement, where men can go along and engage in a hobby and whilst they are doing it they are opening up to other men and talking about things that are important to them. Some of the people there who have experience in the issues that men feel uncomfortable about can offer advice and solicit support for them. This is a very important movement. It is an informal movement, and how we support it and encourage it without bureaucratising it I think is a great challenge for government, because in this instance government is more the problem than the solution. But government can play a big part in the solution by providing adequate support and adequate funding for it.

All of this is dealing with men in later life. One of the great challenges for all of us as members of the Senate and members of parliament is to change the country, and the greatest way to change the country is to influence the behaviour of our children, because they are the generation that will be making decisions. I see a number of children up there in the gallery. They are going to change this country for the better, and we need to instil good habits in them. We have done it in many ways. We have already talked to them about being sun aware so we reduce the incidence of melanoma and things of that nature.

What we also need to do is engage young boys and girls and teenagers in preventative measures. We need to explain to them and show them that there is a real benefit for them later in life in moderating their risk, looking after themselves and seeking appropriate treatment as it comes along. The committee found that this view was widely supported across the community. It is not just about looking after people when they have a problem; it is about instilling self-awareness so that if people are having mental health or physical health issues they know how to respond to them and to treat them.

In conclusion, men’s health is a serious issue—it is serious for men, it is serious for our nation, it is serious for our communities and it is serious for our families. It is not one of those areas where we can say, ‘She’ll be right, mate’—or ‘He’ll be right, mate’, I should say—because, in the end, we need to change behaviours. We need to enhance good behaviours, and we can do that in any number of ways, a few of which I have outlined here today. I sincerely hope that men’s health will not be just something we are concerned about a couple of times a year, for ‘Movember’ and Men’s Health Week. It is something that needs a whole-of-government approach; it needs a national approach and it needs an all-encompassing view—physical, mental, social and societal. They are the sorts of things we should be looking at. I hope that the committee’s report will play a small role in this. I know it is something that many senators are very interested in. I thank the Senate for its time.