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

by leave—This report of the Standing Committee on Health, Aged Care and Sport took over 18 months, and we heard from people all around the country about the public health emergency that is diabetes in Australia. We know that there are approximately 150,000 people with type 1 diabetes, over 1.5 million people with type 2 diabetes and more than that number with prediabetes. It's a major public health emergency. We have seen that almost 50 per cent of presentations to our emergency departments are related to diabetes in some way, from complications like renal failure, cardiovascular disease and retinal disease with visual impairment to all the other long-term complications of diabetes, leading to huge pressure on our health system. Peripheral vascular disease, which is preventable, is often a presentation of people with type 2 diabetes. We are doing more amputations in Australia than we should be because of this scourge of diabetes. It's a huge burden on our health system.

This inquiry is important, as it looks at how we could change this narrative and trajectory, because, if we don't, our health system will not be able to cope. We've already seen in areas like the Northern Territory the scourge of renal failure even at a relatively young age. This is people in their 20s with renal failure requiring dialysis because of type 2 diabetes. The trajectory is very bad. In my medical lifetime, we've seen persistent increases in life expectancies every year. In the lifetime of my parents and grandparents, similar has been true. But we are now in a time where, in the developed world, life expectancies are plateauing. The increases in life expectancy that have been seen for over three generations are now changing. In some states in America, they're actually seeing decreases in male and female life expectancies.

One of the big causes of this in the developed world is diabetes. In particular, diabetes is affecting those in disadvantaged communities. We see this in Australia. Type 2 diabetes—not type 1 diabetes—tracks disadvantage. We see this in the outer suburbs of our major capital cities. We see it in western and south-western Sydney in electorates like mine, Macarthur, and in electorates like Fowler, Werriwa and Lindsay where there are very high incidences of diabetes. It is putting enormous pressure not just on our health system but also on our social security system and even on our education system, with many adolescents now presenting with obesity and type 2 diabetes. It is very prevalent, as has already been mentioned, in our Indigenous community. It's now appearing in our Pacific islander community and in our subcontinental communities. The increasing incidence of obesity and type 2 diabetes is causing major health complications.

I started the type 1 paediatric diabetes clinic at Campbelltown hospital 30 years ago. It was becoming apparent then that the management of diabetes was very complex and required a team approach. It was difficult to provide that in private practice. We started that type 1 diabetes clinic at Campbelltown hospital many years ago, in the 1990s. Then, about 10 or 12 years ago, we started to see an increasing number of children presenting with obesity and type 2 diabetes. As we travel around our communities in outer metropolitan areas, rural areas and regional areas, and as we travel to Indigenous communities in remote areas, in particular, we are finding this problem of early onset type 2 diabetes. This is causing an early trajectory towards complications like vascular disease, blindness and kidney failure. These communities are now being devastated by the numbers of adolescents and young adults who are presenting with type 2 diabetes and all its complications. This trajectory has to be changed. It's bad for the communities, it's bad for the wider Australian society and it's something that we need to reverse if we are going to see a return to continuing increases in life expectancy in a well-developed and wealthy society like Australia—hence, the report.

The report has 23 important recommendations that have already been spoken about. Some are controversial and some are not, but they need to be taken in their entirety. We don't want this report to be left on a shelf gathering dust. It's now my job to take this around the country, and I'll be speaking to state health departments and state health ministers about how we can get implementation of the recommendations from this inquiry. As I said, there are 23 of them. Some of them require some investment, but that investment will reap financial rewards if we can turn this epidemic around. That is now my job. It is a public health emergency, as I've said, and it requires a public health response which can only be led by governments from all persuasions, from local to state to federal.

I think that if we are going to turn this around it is going to require action as soon as possible. That is going to depend on many of the committee members who gave their time and their efforts to the inquiry. In particular, I would like to thank the co-opted members—Graham Perrett, the member for Moreton, and Sophie Scamps, the member for Mackellar—as well as my medical colleagues and non-medical colleagues on the committee. I'd like to also pay tribute to Peta Murphy, who was a member of our committee until her death. She understood the social determinants of health very well, was committed to our inquiry and was a big part of our recommendations.

I'd like to thank those who provided submissions to our inquiry, from Diabetes Australia to JDRF. All of the major medical institutes provided supports for us. In particular, I'd like to single out the Grattan Institute, who provided a very comprehensive view of the social issues involved with type 2 diabetes and obesity. And there were all the other institutes in places like Darwin in the Northern Territory, where the Menzies Institute was able to provide very good evidence of the difficulties that diabetes was causing in remote and rural communities.

I would like to thank all the kind words that my fellow committee members have said about the report, and about me in particular. But I'd like to stress that this is a report of the whole committee, and I'm incredibly grateful for all the work they put into what I think is a very important inquiry and what are very important recommendations. I am committed to making sure that we have uptake of those recommendations. I know the health minister has looked very favourably upon our recommendations and is doing his best to help with the adoption of the inquiry's recommendations.

We know that prevention has to be the main aim. If we continue on this trajectory of increases in the number of people with diabetes, our health system will be put under unbelievable pressure and other health priorities will suffer. I commend the report to the parliament and I commit to continuing to impress upon those in power the importance of taking up these recommendations.

Debate adjourned.

Federation Chamber adjourned at 17:37

See this speech in context