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

I'd like to thank the member for Goldstein for bringing forward this matter of public importance. I'd like to thank all the other speakers. I know that many speak from very personal involvement with patients with eating disorders, family members with eating disorders and close contact with constituents who have family members with eating disorders.

As a paediatrician, I've looked after children with eating disorders for many years. I've looked after children with a whole range of illnesses, some very severe and some fatal, but the issue of a patient with an eating disorder is far more complex than virtually any other illness that I've looked after. I've had discussions with multiple health ministers at the state and federal levels over many, many years. What I do know is that we have talked about this issue for decades. I don't doubt the goodwill of any of the previous ministers involved. I know Greg Hunt, when he was health minister, worked very hard with the member for Fisher to look at resources for managing people with eating disorders.

Unfortunately, much of what we've done in the last four or five decades has suffered from a lack of data—a lack of information and a lack of an evidence base. I've looked after a number of patients with eating disorders, some of whom, unfortunately, have died. I know that recently, during the pandemic, presentations of children with eating disorders to my local hospital and most hospitals around the country increased. The ages are getting younger. But we are still faced with a situation where the frustrations of all the clinicians involved and the frustrations of the families have not been dealt with. We need far more research into the issue of eating disorders. We need a far better ability to work out prognosis for children—and, indeed, adults—who present with eating disorders. We know that there are some risk factors. The member for Kooyong very effectively mentioned some of those risk factors. It affects those in a higher socioeconomic group; mostly females, but some males; and those with psychiatric features, such as obsessive personalities. There are some warning signs, such as weight loss; hirsutism, developing hair in inappropriate places; avoidance of family meal times; and overexercising.

We don't know exactly which children and people are most at risk of poor outcomes. The member for Robertson mentioned some of the metabolic effects of eating disorders. They certainly can be quite subtle sometimes to pick up and they can be quite dangerous to manage and require highly specialised care. There has been discussion already today about the number of beds around Australia for children and adolescents with eating disorders. It's very small. It's sometimes hard as a clinician to get a patient who is severely metabolically unwell into an inpatient bed that can deal with severe metabolic problems.

Refeeding someone who has starved themselves almost to death is not simple. People can actually die from refeeding, so putting a nasogastric tube in and feeding them enterally is not always simple. It requires very complex management of their metabolism, as the member for Robertson has already mentioned. Measuring salt and calcium balances et cetera, dealing with cardiac complications and dealing with neurological complications can be very complex.

The Albanese government, like the previous government, is committed to trying to make things better for these families. It is very destructive for the families. We need more evidence, hence the investment in the Charles Perkins Centre eating disorders unit and investment in more inpatient beds. This is a very complex issue that requires highly specialised care, long-term data collection and evidence based treatment. It is not simple. No-one that I know knows all the answers about managing a child in particular with an eating disorder.

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