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

I move:

That this House:

(1) notes that:

(a) skin cancer, particularly melanoma, is and remains a greatly concerning health problem in Australia;

(b) Australians require more equitable access to skin cancer checks with the need for greater access through general practitioner (GP) clinics and dermatologists;

(c) early diagnosis is the key to good outcomes;

(d) not-for-profit groups, such as the Australian Skin Cancer Foundation and the Cancer Council, are the key to better awareness of skin cancer and the importance of early diagnosis; and

(e) diagnosis is being inhibited by the costs involved in GP and dermatologist skin cancer checks; and

(2) calls for the consideration of a separate bulk-billed GP and specialist item number for skin cancer checks.

Skin cancer is a huge health problem in Australia and in other countries. Unfortunately, Australia leads the world in melanoma diagnoses per capita. There are also a very large number of people diagnosed with other forms of skin cancer, such as squamous cell carcinoma and basal cell carcinoma—many more than in other countries. In the average year we have about 13,000 diagnoses of melanoma in Australia, and over 950,000 non-melanoma skin cancer diagnoses. That's a huge number, and a huge burden on the health system.

The causes of skin cancer can be complex, but the two main factors are: No. 1, exposure to ultraviolet light, which we get in Australia because of our climate, and the other is genetics. People with pale skin and blond or red hair are at much higher risk of skin cancer than people with olive or dark skin. Australia, because of its history of colonisation by the Europeans, has the genetics that increase the risk of skin cancer, and also very high ultraviolet light exposure.

Melanoma is the most serious form of skin cancer; it can spread very quickly, and its growth can be very rapid. Early diagnosis of melanoma and other forms of skin cancer is very important for a cure. We know with melanomas that if they have, at diagnosis, less than one millimetre thickness, then there's a well over 90 per cent chance of survival for 10 years. However, once the lesion is more than four millimetres in thickness, there's only a 50 per cent or less chance of survival for 10 years. So the important thing to know is that early diagnosis is very important, as is prevention.

Things have changed in Australia: in my childhood there was a very limited understanding of the causes of skin cancer. We were all exposed to ultraviolet light unwittingly and without the use of sun protection or proper clothing, and for prolonged periods of time. Those in many occupations, such as people who work on the land and people who work outdoors, have a much higher incidence of skin cancer, unfortunately. And whilst melanoma is the most serious form, other forms of skin cancer can be quite disfiguring. Basal cell carcinoma can invade local structures, particularly around the head, neck and face, and can cause quite disfiguring scars when removed. Very rarely it can metastasise—that's quite rare with basal cell carcinomas. Squamous cell carcinomas, however, can cause multiple lesions and can metastasise. Whilst it doesn't grow as quickly as melanoma, it can be a serious and life-threatening illness.

Diagnosis can be quick, but we have to give people access to treatment. Very briefly: before I came to the chamber this afternoon I rang around several of my local clinics. To see a dermatologist in Campbelltown there's no bulk-billing and the average dermatologist charges almost $300—$290, to be exact—with a rebate from Medicare of $78. So there's an out-of-pocket cost of well over $200. That's very expensive for people at this time of cost-of-living stressors. GP skin cancer clinics charge less, at $220 and with a rebate from Medicare of about $60, but the wait time is almost six months. So it's very hard for people to access skin checks. I think it's very important that we consider a special bulk-billed item number for GP and dermatologist skin checks so that people can access timely, early assessment, because that is the key to diagnosis and that is the key, particularly with melanoma, to long-term survival.

We need to get people aware of the importance of things like melanoma. I've seen melanoma in retinas, in ears, on feet and in nail beds. It can occur in places that are hard to see, so it is very important that people are aware of the importance of a full skin check.

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