Margaret May (McPherson, Liberal Party, Shadow Minister for Ageing) Share this | Link to this | Hansard source

I am delighted to speak on Weighing it up: obesity in Australia, a report I commend to the House, in particular the recommendations the committee has made to the parliament. I commend our committee chair, the member for Hindmarsh, who is in the chamber today, for his leadership in this inquiry. It was an important inquiry for everybody in Australia. I also commend our deputy chair, who is also in the chamber today.

We have some alarming statistics in this country on obesity, and I would like to put a few of those on the record today. An ABS survey in 2007-08 found that 68 per cent of adult men and 55 per cent of adult women were overweight or obese. That means that one in two Australian adults are overweight or obese, and up to one in four children are also overweight or obese. We know, and we certainly heard during the committee inquiry, that the prevalence of obesity has doubled over the last 20 years. It is at the stage now where it is a serious health problem in this country, and this report has gone a long way to addressing some of the issues, concerns and things we can do in this country to really tackle the problem of obesity.

Access Economics recently reported the economic costs of obesity in Australia for 2008 to be in the region of $58.2 billion. That is a lot of health dollars going to helping people suffering from obesity. We know obesity is associated with, and increases the risk of, many chronic diseases. For example, being overweight is a risk factor for coronary heart disease and stroke, Australia’s first and second biggest killers. Three other risk factors that we know of—tobacco use, poor diet and lack of physical activity—contribute to the four major chronic diseases: heart disease, type 2 diabetes, lung disease and many cancers, which are responsible for more than 50 per cent of deaths around the world.

With our ageing population, which I have a particular interest in, our healthcare system is going to be increasingly unable to cope with the demands placed on it by people suffering from preventable diseases. The World Health Organisation has identified some shared characteristics of chronic diseases. Chronic disease epidemics take decades to become fully established. They have origins at young ages. Given their long duration, there are many opportunities for prevention. They require a long-term and systemic approach to treatment. Health services must integrate the response to these diseases with the response to acute infectious diseases.

While many factors may influence an individual’s weight, fat is deposited when the energy we consume from food and drink is greater than the energy we expend through physical activity and rest. I think each and every one of us in this parliament knows that is exactly what we are doing to ourselves. We know that what we intake we have to get rid of some way. I think each of us here in the parliament has a responsibility to set a very good example of what we can do as far as setting that example for Australians in how we maintain our healthy lifestyle and our eating habits. It certainly came out through the inquiry that portion size on the plate really does matter. What goes through the lips ends up on our hips. We have all heard that, we all know it and we all grapple with it day after day. It is a huge temptation, and it takes a lot of willpower to ensure that what we put on that plate is of benefit to us.

In this country we also have the opportunity to get out and do some exercise. We know exercise and food intake is part of a healthy lifestyle. Although looking at the weather in Canberra today we probably do not want to be outside, we all know that even 30 minutes of walking makes a big difference to our health lifestyle and how we look after ourselves and our health, particularly as we are getting older. It is a simple matter of exerting more energy than we consume, and that certainly comes through in the report.

One of the report’s recommendations which I was particularly interested in is for better urban design in our cities and suburbs to encourage people to be active. I particularly want to commend the Gold Coast City Council for their Active and Healthy Citywide Program. They provide free and low-cost physical activities right across the city. They are also building bike tracks to encourage people to use their bikes. We have an ageing population on the Gold Coast, a lot of seniors, so there are a lot of walkways being built for them, with safety in mind. I think our senior Australians need to know that they can get out and be part of their communities in safety, and we are certainly encouraging that in our city.

There is also a study currently being undertaken at Bond University by Professor Greg Gass. He came to the committee hearings that were held on the Gold Coast and shared with us the study he was undertaking. It was to do with walking and the effect walking has on type 2 diabetes. In the last couple of weeks I visited the women who are undertaking that program at Bond University. They are halfway through the program, and I hope that seeing the outcomes of that study, when completed, will be of benefit to the parliament and to the health and ageing committee. We also need to encourage our children to get out and be healthy and active. We know young people go to school and have to spend a lot of time in school, but we also know they spend a lot of time playing computer games. I think we need to have programs to encourage kids to get outside.

One of the recommendations we made is about getting community groups and partnerships involved in healthy lifestyle programs. We were all very impressed with a program we saw in Melbourne, the Stephanie Alexander Kitchen Garden program. For all the members who visited that school in Melbourne, it was wonderful to see the kids growing those vegetables, taking care of them, picking them and then ending up with them in the kitchen, where they actually cooked us lunch. It was a fabulous experience and I think every one of the committee members would say that it was a fabulous lunch. We had no meat with that lunch. It was the fruit and vegetables that these kids had grown, and that program is to be commended.

Some schools raised concerns about the difficulty of the criteria and the eligibility for applying for funding for that program throughout Australia. I hope the government will take those concerns on board so that we, as a committee, can see that more and more schools throughout Australia take on that program at school level. We need to teach children the value of eating properly and growing their own vegetables. Even in today’s climate, where families are struggling with the family budget, we saw that you can grow those vegetables on very small plots of land. I think we should continue to encourage kids to do that and set those good examples for their future lifestyles.

I was particularly interested in the inquiry we undertook. Twenty recommendations have come out of the inquiry and I commend everybody who was involved in it, including all the people who gave us evidence through the inquiry. There are a lot of things we, as a country, and the government can look at, such as the food-labelling issue. Most of us cannot read the labels on tinned foods in supermarkets, and I think we need to have a look at how we can do something about labelling in particular. As I said, I commend our chairman, the committee for a wonderful report and the committee secretariat for the support they gave us during the inquiry.

Steve Georganas (Hindmarsh, Australian Labor Party) Share this | Link to this | Hansard source

by leave—I also want to speak about the obesity report that I tabled in the parliament a couple of weeks ago. I will only be speaking for a short period because I have already spoken about it. I thank the House for granting me leave to speak a second time. This very important report looked into obesity in this country. As the member for McPherson said, it showed that 68 per cent of men and 55 per cent of women in Australia are either overweight or obese. That makes us one of the most obese countries in the world, with one in two adults and one in four children being either overweight or obese.

We saw many things in the course of the inquiry. For example, we saw the Tai Chi classes that the Gold Coast City Council was conducting for residents at a very minimal cost, giving people the opportunity to go out and exercise in the morning. We saw the kitchen garden program operating in Westgarth Primary School in Northcote, where children were learning the art of cooking—something that we heard has been lost over one generation. Previously we would all come home to a meal that was nutritional and that contained all the vitamins and everything we needed. We are now finding that we are living extremely busy lives. Both parents are working long hours and the children are at school and when we come home we sometimes find it much easier to either get some takeaway or just have a quick fry-up, which makes it very simple. From the evidence that was given to the inquiry it was quite plain that this type of lifestyle was one of the reasons that we are becoming overweight and obese.

As the member for McPherson said, it was extremely heartening to see a program in Westgarth Primary School where these children, at a very young age, are taking part in nutritional education and learning skills that they need to live a healthy life. Whilst we were there they cooked us a magnificent lunch. The children grow their own vegetables within the school grounds. They learn the science of growing vegetables, which is like a science lesson for them. They learn how to prepare the vegetables and the art of nutritional cooking. While we were there the children cooked up a mixture of food. I recall having an Indian dhal curry. It was fantastic to see these kids understand what food is meant to be like, and that we can enjoy not only eating it but also the social contact it provides.

One of the questions we asked these children is, ‘Do you eat this food at home?’ They said that they encouraged their parents as much as possible to use the ideas that they bring home from school in their cooking. I asked one of the young children, ‘What do you do when your parents suggest that you get some takeaway?’ Her immediate answer was: ‘We tell them off. We tell them it is not good for you.’ Here is an example that is actually working. This was one of our recommendations in the inquiry—that we ensure that we educate the next generation of children to go through life with the right healthy, nutritional habits that we have lost, because of our busy lifestyles, in one generation.

One of the other areas that we looked at and that got a lot of coverage after the report was tabled was lap band surgery. We took some evidence from a great witness in Sydney who had had lap band surgery. She was a barrister and she had done all her homework. She came to the inquiry with documents listing all the medical expenses—from medicines to doctor’s visits—she incurred to treat the ailments which had resulted from her obesity prior to having lap band surgery. She then had documents outlining the costs of the lap band surgery and the costs of the allied services that went along with that surgery; in other words, psychologists and the whole range of things needed to get the mind in order as well as the body. She incurred huge expenses before the lap band surgery. After the surgery, over a period of time, all those expenses began to diminish because her health was in a much better state. We found that, firstly, the surgery was good for the person with obesity because they immediately lost weight; and, secondly, the costs of medication were dramatically reduced, therefore saving money for both the person and the government in the long run. We found from an Access Economics study that was done recently that obesity is costing us close to $60 billion.

One of our recommendations was to ensure that we could get more people onto bariatric surgery. We are not talking about people who just want to wear a pair of bathers at the beach and look good; we are talking about people who are morbidly obese and who have tried absolutely everything to lose weight. Their health is being affected. The cost of looking after these people because of their obesity is escalating. In most cases, these people have no other choice and will go on to develop further ailments and illnesses and, in the worst-case scenarios, die. It was most evident in the inquiry that, with this surgery, there would be a reduction in costs to the government and there would certainly be health benefits to the patient.

Some of the other things that we saw included urban planning, which was mentioned earlier. Urban planning is very important. We found that, for every new development that is opening up, councils and planning departments immediately ask for a hundred car parks or whatever for these businesses, which only encourages people to drive their cars and park them in front of the premises, the shopping centre or wherever they are going without thinking about public transport or perhaps walking or riding a bike. I think our planning laws over the last 50 years have just been catering for the motor vehicle and, therefore, we human beings, who used to do all our business by walking in our communities and our neighbourhoods, now have to get into a car and drive to a shopping centre, get out, do our shopping, get back in the car and then drive back home. We found that urban development and urban planning will play a huge role.

Another recommendation was about labelling. We saw quite clearly, through witnesses who came to speak to us, that people want to eat the right foods, but sometimes there is a myriad, a maze, of labelling and people cannot read through the labelling. We said that we need to simplify that labelling to conform across Australia and ensure that it is as simple as possible to read for the consumer at the point of purchasing a particular food product to know exactly what is in that product. They can then make the choice of whether they want to eat something that has high sugars or low fats et cetera. We found that at the moment it is a very difficult maze for people to get their heads around, so we have asked that industry and government get together and try and come up with some good, simple labelling that gives the information to the consumer while they are making the choice of purchasing the food product.

I will not go on any further. I will just thank my deputy chair, Steve Irons, the member for Swan, the other members of the committee who are here today and all the other members of the committee for their tremendous support and the work that they did in preparing this report. The report has been tabled. It is now in the parliament. It is there for all to see and to use as they see fit. We are hoping that some of these recommendations will come to fruition so that we can go on to live healthier lives and ensure that we are not going to be the first generation to live for a shorter time than the previous generation because of the difficulties and health issues that we will develop because of obesity.

Steve Irons (Swan, Liberal Party) Share this | Link to this | Hansard source

I rise to talk about the House of Representatives Standing Committee on Health and Ageing report Weighing it up: obesity in Australia. I acknowledge the contribution of the member for Hindmarsh and the member for McPherson. I also see other committee members here. The member for Dawson and the member for Kingston are in the chamber, and I look forward to hearing and reading their contributions as well, particularly that of the member for Kingston, who gave us a great display of Tai Chi prowess on the Gold Coast trip that we had. I am sure her hamstrings are still suffering from that trip, but it was a great display of Tai Chi.

I spoke about this report previously and endorsed the chair’s comments at that time, and I also acknowledged his efforts during the inquiry. Again I say to you, Steve Georganas, the member for Hindmarsh, thank you. I would also like to take this opportunity to recognise the efforts of your staffer Heather Atcheson, who travelled with us on some of the hearings and helped us tremendously during that period of time. If you could pass that on to Heather, that would be great. I also acknowledge the previous deputy chair of the committee, the member for Menzies, Mr Kevin Andrews, whose place I took on this committee. As I said previously, some of the other committee members are here, and I look forward to their contributions, as they were contributing during the inquiry as well.

This inquiry was into what is seen as an increasing problem in Australia—the level of obesity amongst adults and children of our nation. This report made 20 recommendations, ranging from urging the government to continue supporting existing programs, such as the Active After-school Communities program and the Stephanie Alexander Kitchen Garden Program—which unfortunately I was not able to attend, because I was not on the committee at that time, but listening to the member for McPherson and the member for Hindmarsh it seems as though I missed out on an excellent meal and contributions by some young people in our community—through to recommending the development and implementation of the healthy food code of good practice in conjunction with industry. The recommendations considered tax incentives and what more could governments do. Food labelling was considered—and I know the member for Kingston was particularly enamoured with that approach. She unfortunately did not get up the recommendation that she wanted, but it was a great effort and she did a lot of lobbying in the background. Urban planning was seen as an important step to encourage Australians to be healthy and active.

While the report recognises that individuals are ultimately responsible for their own health and wellbeing, the inquiry has highlighted that the modern environment in which we all live can make weight loss very difficult. It is stated in chapter 6 of the report that any strategy to successfully combat the growing problem of obesity will need to include community involvement and programs that are community centred. All three levels of government will need to be involved and be supportive of any group within the community that runs programs that are designed to encourage community participation and involve people from the local community to take ownership of these programs.

Many areas were covered in this report. As the chair mentioned, the personal, economic and social costs to Australia from obesity place stress on our community and health services in all areas and underpin the need for action. Many people have different and varying views on this subject, extending from the simplistic solution—which someone contributed to me on a flight coming over from Perth one day—of increasing breastfeeding rates in Australia from 19 per cent to over 50 per cent to help fight obesity and other chronic illnesses in our society to another simple act of reducing our intake of fructose.

Community awareness of this societal problem is increasing, and we must continue to alert all Australians to the benefit of a healthy lifestyle. In my previous speech I mentioned that I personally tried fructose reduction in my diet and six months later I am 10 kilograms lighter.

James Bidgood (Dawson, Australian Labor Party) Share this | Link to this | Hansard source

Mr Bidgood interjecting

Steve Irons (Swan, Liberal Party) Share this | Link to this | Hansard source

I will take that as a compliment, thank you. I thank David Gillespie, who came and presented to us on the Gold Coast, for his evidence and his book Sweet Poison, which I know some of the committee read. I know the member for Kingston had doubts about it, but I am living proof that it does work. It focused my thoughts on what I was eating, on my intake, and also on my output of physical effort. Again I thank David Gillespie. Not every solution is going to work for every person but it has worked for me, and I think if that can help other people to focus on a healthy lifestyle and activity that would be great.

On the matter of submissions to the inquiry, I must congratulate all the groups, associations, businesses and individuals who presented to the committee. The individuals who had the courage to tell their stories were fantastic and I applaud them. The member for Lyons came and spoke to us as well. I was not at that particular hearing, but I applaud him for his opening up about his personal situation. The report also dealt with bariatric surgery, which is the surgical reduction of the stomach and includes lap band surgery and gastric bypass.

Unfortunately the media focus after the release of this report was on the recommendation that said, ‘Obesity should be placed on the Medicare Benefits Schedule as a chronic disease requiring an individual management plan.’ The media were more interested in the fact that this would lead to people obtaining free surgery for stomach lap banding at the expense of the taxpayer. If the media had bothered to understand the full implication of the report, they would have understood that the inclusion of this type of surgery on the Medicare schedule would give access to people who could not afford it and, from evidence given during this inquiry, to people from lower socioeconomic areas, who are most likely to need the surgery. The benefits to society would far outweigh the costs and might also lead to social and economic benefits as well as just health and physical benefits. The media failed to recognise that the report indicated that people in certain environments need assistance and this surgery would have been a final solution, not a first choice, for anyone who qualified for lap-banding surgery.

The reports we received on this surgery are positive but, again, as the chair stated, the committee is wary of giving open slather access to bariatric surgery. It has to be maintained in a clinical program, and many aspects of that program would need to go to the wellbeing of the people who are involved in bariatric surgery. On radio 6PR in Perth, this report was discussed on talkback radio twice during the day after it was released, with some radio callers calling in saying how their lives had changed since the surgery.

We must all treat obesity as not actually a disease but a result of the person’s environment, lifestyle and eating habits. A holistic approach should be taken. The chair stated in his speech that a number of witnesses called for changes to be made to the health system to better treat and manage Australians who are overweight or obese. I believe that the committee has made recommendations in this report that will put Australia on the pathway to achieving a reduction in obesity levels in Australia.

Before I conclude, I would like to say that in my electorate I have started to implement a program which will be called the Swan 10/10 program. That will involve the community as a whole in active lifestyles and healthy eating options. We are just getting our ducks in a row and making sure that all the i’s are dotted and the t’s are crossed before we launch the program. I look forward to that, and it is purely based on the efforts of this obesity inquiry that I have decided to activate a combination of the Gold Coast program and the WellingTONNE Challenge in my electorate. I hope this report contributes to the bettering of our lifestyles and health in Australia. I commend the report to the House.

James Bidgood (Dawson, Australian Labor Party) Share this | Link to this | Hansard source

I rise to speak concerning the report that we have before us, which is Weighing it up: obesity in Australia. The committee has weighed it up, and the facts are that we are one of the most obese nations in the world. It is like the antismoking advert. We all know what we have to do. We all know that we need to exercise, to eat properly and to drink responsibly. We cannot afford to avoid the situation of obesity in our society. We have to address the situation as we have it now. We have overweight people in our nation far and above any other developed nation in the world, so we need to address that. The most important recommendation in this report, from my perspective, is recommendation No. 7, which says:

The Committee recommends that the Minister for Health and Ageing place obesity on the Medicare Benefits Schedule as a chronic disease requiring an individual management plan.

I personally argued very strong and hard that this be placed as a recommendation. Having run medical centres for nine years, looking after 10 GPs, 20 staff and the healthcare needs of 40,000 patients in the Mackay region, I have seen the success of management plans concerning asthma, diabetes, mental health and the aged, and this is what we need.

If we are serious as a government and a nation, from a bipartisan point of view, if we really care about our people and we really want to do something constructive, this recommendation is an absolute necessity. It will give GPs, who are mainly the first port of call for people in our community, the access not just to a weigh up to see how overweight you are but to a holistic plan, including the psychology of how you are motivated to do what you need to do. A lot of people lack motivation and self-esteem, and it becomes a vicious circle. Psychology is very important in breaking that vicious circle. We need to get people from the point of hopelessness, where they just feel they cannot do anything anymore about their situation, to a point where they believe: ‘Yes, I can change. Yes, I can do it.’ That motivation is very important.

In a multidisciplinary plan, such as a Medicare obesity plan, we can have psychology and we can have dietitians advising the best types of food and not to go on radical crash diets. As you know, we go into those diets with New Year’s resolutions and by February it is all over. We need realistic, sustainable dietary plans. This needs to be backed up by realistic physical exercise regimes. The fact of the matter is we are a very sedentary nation. We drive everywhere, we do not walk as much as we used to and we spend a lot of time in front of televisions and computers.

The basic bottom line here is: we need to get moving. The most realistic and easy way to get someone moving is to say, ‘Go for a walk.’ People who are obese are often very self-conscious about their size and have poor self-image. We need to encourage people to do basic things every day which are achievable, such as get up early in the morning, walk 15 minutes in one direction, stop, turn around and walk back home. That is very achievable. But for a lot of people who are acutely obese that is a very difficult thing to do and it is a big strain on their heart. Simple things like that need to be done.

We need to take a holistic approach. We need to take an approach towards psychology, nutrition and exercise and we need to look at the environment in which people live, work and operate. These are very important keys to the holistic management of the problem of obesity in our society. A lot of where we are right now as a nation is due to our wealth and our success as an advanced economy. We have luxuries such as cars, televisions and computers which take up our time and reduce our physical activity. The human being is designed to be functional, moving and engaged in society. Obesity can cause a feeling of dislocation from society. It can cause loneliness and family break-up. These have far wider implications in our society.

Recommendation 7 is, in my opinion, the most important recommendation, which I would like to see adopted by the Minister for Health and Ageing. We need change to address the problem now, and this addresses it. We need the political will. We need the determination to take on this goal to reduce the amount of obesity in our nation. We need to have a clear vision. Part of that is addressed by the economic facts and figures that we have before us in this report. I would like to draw your attention to the National Health Survey, which reported just recently. In 2007-08, 68 per cent of men were overweight or obese compared to 10 years ago, when it was just 64 per cent. In 2007-08, 55 per cent of women were overweight or obese compared to 10 years ago, when it was 49 per cent. We need to move towards addressing these problems.

Access Economics have worked some figures out on lost productivity and cost to society as a whole in dollar values. In 2008 they estimated the cost to the Australian economy was $49.9 billion. That is a very big figure caused by the very big problem of obesity in our nation. From a purely economic point of view, this needs to be addressed. There has been an increase over the years in discrimination and stigma and, as I said, the social isolation of people who are obese. They have lower levels of occupational prestige and lower levels of income. There is more sickness and there are more unemployment benefits being paid. There is a lower workforce participation rate and much higher absenteeism. This is having a very direct effect on the productivity of our nation. Just the productivity in the workplace is estimated to be worth $3.6 billion. Productivity is, in the long term, the key to building a more internationally competitive economy. So obesity has far more wide-ranging ramifications in our society than just the personal and local. It affects the whole community, the whole nation and our exports as well.

The reason I am so passionate about this subject is that it is at the very core of our existence and our being to have people who are functional in our society—people who are holistic and happy in mind, body and soul. That is why, as part of the Rudd Labor government, I am so passionate about sports in our society. That is why I have been so passionately fighting for my community to have excellent sporting facilities, such as the Mackay rugby league stadium, for which I managed to get $8.8 million of funding, and, for Mackay cricket, the Harrup Park Country Club, which will have facilities of international standard worth $1.3 million. I am also proud to say that I managed to get funding of $114,000 for the Dolphins Soccer Club in Northern Beaches, Mackay.

It is important to have our people engaged at a young level. Our children are our future. It is a cliche, but it is true. We need to set a child in the direction of the way and the manner that the rest of their lives will be. I personally have a very strong issue about having no salt in our diet. At the age of 50 I can honestly say I am glad I made a decision 20 years ago to cut salt completely out of my diet, along with sugar, and to reduce my intake of fat and other not-so-healthy foods. I can say honestly that my heart rate is way better than, perhaps, is normal for my age, even after doing a massive workload and carrying on in the stress of the job that I do and also in the physical activities that I do. We need to set examples as politicians. We need to get down to the gym. We need to walk in our communities. If we do not do that then who are we to say to others, ‘This is what you should do. This is the way to live a healthier life’? We need to get children into the routine of exercise through sport. We need to get them out walking as a family. Whether you are a single parent or in a couple, you need to go walking with your kids. It is a time to communicate and it is a time to exercise. As I said at the beginning of this talk, it is achievable, it is realistic, it is not hard. We need to get our nation moving.

I commend this report because it really does address important issues in our society. This is an excellent report and I wholeheartedly endorse it. Of all the things I have done in this parliament, being involved in this report is the most satisfying thing I have done to date. I wholeheartedly commend it to the Minister for Health and Ageing and also to the Main Committee.

Mark Coulton (Parkes, National Party, Shadow Parliamentary Secretary for Water Resources and Conservation) Share this | Link to this | Hansard source

I also am pleased to speak today on the report from the House of Representatives Standing Committee on Health and Ageing, Weighing it up: obesity in Australia. I will not take a lot of the House’s time. A lot of this has already been said. I just will comment on a few things that I picked up from undertaking my role in the committee to put this report together. I guess what really was highlighted was that obesity is a very complex problem. While this report is certainly not a solution to the problem, I see this as a tool for, hopefully, legislators in this place and also in other places around Australia, including local government, urban planners and whatever. I hope they will take the information that we have put together in here and use it however it is applicable to their area.

We looked at a lot of different aspects in this report, from preventative measures with children right through. One of the more interesting and more sobering presentations was from Hunter New England Health. They spoke about the added cost to the healthcare system from morbidly obese people. I got hope out of this, as well. We had a couple of visits. We went to Marks Point Public School in the member for Shortland’s electorate, and we played sport there. I have to say that these kids were not selected athletes; they were the entire section of the school in that age group. They were healthy, active kids. There was no-one there that obviously, I do not think, had an unhealthy weight.

On another one we went to a primary school in Melbourne, where they were growing their own vegetables. City kids not only got the idea of where food came from and the joys of actually growing something—some of us who grew up in the country probably take that for granted—but also got to learn how to prepare that food. They said that, because of the lifestyles of their families, they very rarely ate together as family units. They did not see food that did not come out of a plastic bag. I was quite taken with that.

If there is one thing that comes out of this report it is that obesity is not a condition of affluence. Obesity is a condition of disadvantage and poverty. In my own electorate the highest incidence of diabetes, obesity and heart disease is in the isolated areas—that is, in my Aboriginal community, in the lower demographic. A lot of the things that the previous member spoke about are not achievable in these areas. I was at Collarenebri Central School a couple of weeks ago. They do not have enough senior boys or girls to have a netball or a football team. But, even if they did, they would not have anyone to play against because of the declining population in the area. I think originally there were thoughts that there would be recommendations on junk food advertising and on the terror of the multinational food corporations, but in the areas in my electorate that have this problem there are not any of those. We do not have any fast food restaurants. Indeed, one highlight was the expense of fresh food. I commend the information that came from the Walgett Aboriginal Medical Service. They are not only one of the leading health providers in my electorate but recognised around Australia. They spoke about the problem of not being able to buy healthy food at a reasonable price.

Another issue is education. If you have a young family—if you are a young, teenage mum with a couple of kids—and do not have a lot of education, it is hard to understand why you should pay more money and go to the trouble of preparing a healthy meal for your children when they can be easily satisfied by chips and gravy. That is the word of a witness quoted in this report. That is entirely correct. I have a relationship with the Lifehouse in Dubbo, which is run by the Riverside Church in Dubbo. It is a voluntary organisation. They are trying to reach out to these young mums. They have a food bank, where people can come along and for $25 buy approximately $80 worth of food. There is quite a complicated network to get that food there, but it is a fantastic thing. I have been trying to get funding for this since I came into this place. All they want is somewhere for the children to play so they can be supervised. Then the mums could be taught—you know, with a bag of rice and a few vegetables—how to serve a nutritious meal to their family, as well as freeze half of it and feed them again in a couple of days time, for not a lot of money. I commend the people that are doing this sort of thing.

Really, if we are going to address this problem, we need to start with the kids. It needs to be like seatbelts and smoking. I do not know how many people gave up smoking or started wearing seatbelts because their kids nagged them. I took great heart in what I saw with the kids coming through. But I will go back to the disadvantage. While it would be lovely to go walking as a family, in the housing commission areas in south Dubbo there are no footpaths. If you want to go walking with your family, you have to walk on the road. If you want to walk to the local shop, you have to cross over the Mitchell Highway. There are things like that, which we take for granted. It is a wonderful thing to do. Despite what might appear obvious, my wife and I walk on a regular basis in Canberra. We see people cycling to work and walking to walk—hundreds of them every morning—but there are cycleways, walkways and overpasses over highways.

There are gyms if you want to use them. The building I live in has a gym in it. This place has a gym in it. My adult children, who work in professions, one in Newcastle and one in Tamworth, are members of gyms. They are members of boot camps that grind up and down hills at 5.30 in the morning. They have all those advantages. But the people in Collarenebri, Mungindi and Walgett or in certain parts of Dubbo, Wellington and places like that do not have that opportunity. So while I am loath to place any more burden on teachers, who are asked to do too much now, I think somehow—maybe not through the schools—we need children to form these habits for life.

I am very pleased with this report. I have to admit I was concerned when we started that we were going to look for an easy answer. The more we delved into it, the more we realised how complicated it is. So I would like to commend Sara, Penny, James and the other members of the secretariat who worked so hard on this. I would like to thank my fellow committee members. Indeed, one of the pleasures of this place, which sometimes may be few and far between, is the committee work we do and the inspirational people we get to meet. In some cases, the grinding poverty that we get to witness has been very rewarding for me. I thank my fellow committee members for their goodwill, fellowship and friendship in putting this report together. I commend this report and I hope that over the years to come many people who are involved in public policy and even private policy can use this as a very worthwhile reference tool.

Amanda Rishworth (Kingston, Australian Labor Party) Share this | Link to this | Hansard source

I also rise to commend the House of Representatives Standing Committee on Health and Ageing’s report Weighing it up. I would also like to reflect on some of the comments that have already been made. This report was based on keen interest from all the committee members. We worked in a really constructive way to look at this issue of obesity in our society and how we might tackle it. On the face of it, it seems quite simple to address the obesity problem: people should take in fewer calories and burn off more calories by exercising. But, as we heard during this inquiry from witnesses and submissions, it is not that simple. What is very important about this report is that it picks up on many different levels of our society that need to tackle it. It looks at some of the grassroots programs. It looks at some of the structural issues in our society such as urban planning. It also looks at some things that we as a government can do in collaboration with industry and other groups around the place. So I think it is a report that looks into many different areas.

As we know, the issue of obesity does get a lot of media, and certainly if you put the word ‘obesity’ in something then often it will get attention. I think part of the reason is that, as has been demonstrated as part of this report, there will be some very serious ramifications for our society if we do not tackle this problem. The report highlights that high body weight has been estimated to contribute to 7.5 per cent of the burden of disease in Australia, and this is nearing the 7.8 per cent contribution that tobacco use makes. The scope of this problem can be seen in the latest national health survey from the Australian Bureau of Statistics. The 2007-08 figures found that more adult Australians were overweight or obese in 2007-08 than in 1995. That was when the previous survey was conducted. The survey found that 68 per cent of men and 55 per cent of women were either overweight or obese. It was similar for children. There was a significant increase in the proportion who were obese, from 5.2 per cent in 1995 to 7.8 per cent in 2007-08. So it would seem that we do have a trend where this issue is continuing to rise, and this rise is going to continue to lead to a very serious cost burden on our health system.

In addition to the cost of overweight and obesity incurred by individuals, families and the community, there is a huge financial cost on the health system. As the report indicates, we got a submission from Access Economics who did a report, The growing cost of obesity in 2008: three years on, which updated on their earlier report titled The economic cost of obesity. They found that the total cost of obesity in 2008 was around $58 billion. This sum includes costs of diseases such as diabetes, cardiovascular disease, various types of cancer and osteoarthritis. The figure has risen from the earlier estimate of $21 billion for the total cost of obesity. We can see that the cost of this problem will only increase if we fail to act. These costs will be compounded by the unique nature of Australia’s demographics. The 2008 Access Economics report predicted that population ageing alone will result in 4.6 million Australians being classified obese in 2025. So it continues to be an issue that we must address.

We heard evidence that hospitals were also bearing a significant proportion of costs as a result of overweight and obesity. For example, the report showed that the increased cost of specialised equipment was a major concern for hospitals. We heard witnesses present this evidence. Similarly, there are also many hidden costs resulting from the obesity health issues. Professor Samaras from St Vincent’s Hospital, told the committee:

Every time a coronary artery stent is put in, and obesity is the cause of that, that costs $10,000. You will not see it as an obesity statistic; you will see it as a cardiac statistic.

In fact it is inherently related to the issue of obesity.

The committee realised just how complex this policy area is, and that is why none of the recommendations are a silver bullet. We must acknowledge that the costs to our health system are not the only costs. As the committee observed, there is extensive personal cost incurred by individuals who are affected by obesity. It was very moving to hear evidence from witnesses to the inquiry identifying a number of areas, in addition to financial areas, where people bear what I would call the personal costs of obesity. These costs include particularly devastating emotional harm, from discrimination, stereotyping and bullying, that often lead to mental health issues. This was very important and certainly should not be seen as less important than the cost burden on our health care system.

Some of these negative effects are fuelled by the increased focus on obesity by the community and, although warranted, have had some perverse effects. The report highlights that too much of this media coverage has been overly alarmist and sometimes of a defeatist nature. Although it was recognised that popular weight-loss television shows draw attention to the issue, they can be somewhat extreme. TV reality shows that encourage people to compete to lose huge amounts of weight in a short time—although, once again, they draw attention to these issues—do not really provide people with some solid solutions that they can follow.

In contrast, our report makes numerous recommendations that look at ways that we can improve a number of measures. Particular recommendations need to be highlighted. Recommendation 3 recommends that the minister for health works with states, territories and local governments through the Australian Health Ministers Advisory Council to develop and implement long-term, effective, well-targeted social marketing and education campaigns about obesity, and more importantly about healthy lifestyles, and to ensure that these marketing campaigns are made more successful by linking them to broader policy responses to obesity.

This is important, because as the report shows, social marketing, if well directed, can play a significant role in educating Australians about healthy eating and living. The report makes it clear that the message of the social marketing campaigns can increase people’s demand for healthy products as well as encouraging physical activity and healthy eating to become part of everybody’s daily routine. An example of this is the How Do You Measure Up? campaign which includes a hard-hitting television ad and billboard posters. But this is not enough by itself. As the anti-smoking campaign over the last 20 years has shown, long-term ongoing integrated campaigns are the most successful in influencing behaviour across society. We also heard a lot of evidence from the witnesses and submissions about grassroots programs that are having an effect on the ground. As previous members have mentioned, the federal government’s Active After-school Communities program has certainly been supported.

There are also programs such as the Stephanie Alexander Kitchen Garden program. I felt very lucky to attend the Stephanie Alexander Kitchen Garden program and see it up and running in Melbourne. This program is very inspirational. For people who do not know about the program, kids make a garden with some help from teachers and volunteers. They plant a whole lot of things and then they have a lesson in taking those things from the garden and cooking them, really making that connection between growing fresh healthy food in the garden and learning how you transform that into a cooked meal.

We talked to one of the coordinators, who said that they do not talk about ‘healthy’ versus ‘non-healthy’ products. Really they are looking at making the connection between good food and the kitchen. I talked to some of the children in this program and one comment really stuck with me. I was talking to one of the young people in the program and I asked him whether he takes home some of these lessons in cooking. The young boy said, ‘Well, look, I do. In fact Dad used to cook everything from packets and now I take home the recipes and we cook fresh food.’ I think that was really important and it showed just how this program is making that connection between fresh food and the home environment. As the previous speaker said, our young people have the nag factor for their parents and, if we can get them nagging their parents about healthy eating and good eating as opposed to wanting to eat lollies, then that is certainly a positive thing.

One aspect of the integrated approach to fighting obesity that I am particularly passionate about is an improved food labelling system. I do believe that Australians need good information in order to make good choices and that an informative, simple food labelling system is really important in doing this. As the report shows, there has been overwhelming support for the introduction of an improved labelling system, one that gives you key information that is very visual and placed on the front of the package.

The design of such a labelling system needs a lot of consideration. I know that as a committee we heard a lot of information supporting the traffic light labelling system. This is a system that does have a lot of merit. I will be particularly interested in the report commissioned by the UK Food Standards Agency, which involves an independent group of experts studying over 18 months the most effective food labelling, to see how we might go forward on this. As we know with food labelling, there are always different issues, and I look forward to this report by the UK Food Standards Agency, which might show us how Australia might move forward with better food labelling. I note also recommendation 12, which talks about the industry and the government working together to provide better food labelling.

I would also like to draw the chamber’s attention to recommendation 15, which looks at reformulation of foods. I think it is important that we reduce the amount of salt and fat in our products. We heard evidence from a lot of the canteens that we went to that they are opting to buy pies and pasties with reduced fat and reduced salt so that you can get products that can taste the same that may have reduced amounts of fat and salt and sugar. Recommendation 15 looks at that as well. I know there has been a lot of discussion in South Australia about how we might remove trans fatty acids, which are, from all accounts, a nasty fat, from food products.

In conclusion, the costs of obesity in Australia are significant. The international evidence tells us that Australia is not alone in facing increasing rates of obesity. The World Health Organisation has classified obesity as a chronic disease and, as far back as 1997, declared that:

… overweight and obesity represents a rapidly growing threat to the health of populations in an increasing number of countries worldwide.

This threat does mean that individuals need to take responsibility. The report shows there are factors, though, that impact on people’s ability to control our weight, and that is where industry, government and other organisations have a role to play.

I would like to take this opportunity to thank all the other members of the committee. As I said from the outset, this was a particularly constructive committee report where everyone did work together very well. I would like to thank the secretariat—Sara, Penny, James and the other members—who did work very hard in providing us with a very interesting program. I would also like to thank all the witnesses that appeared before the committee, and those that made the many submissions. This did provide the committee with real fuel for thought, which we have certainly highlighted in the report. There is no silver bullet, but there are things that all levels of government can do, and that industry and individuals can do to address this problem.

Dick Adams (Lyons, Australian Labor Party) Share this | Link to this | Hansard source

It is a pleasure to speak on this very good report. The excellence of this report indicates the importance of the committee system to the House of Representatives and the need to continue to have a well-funded and working committee system.

The report came out of surveys from the Australian Bureau of Statistics that found that more adult Australian were overweight or obese in 2007-08 than in 1995 when the last surveys had been done. The survey found that 68 per cent of adult men and 55 per cent of adult women were overweight or obese. This shows a growing incidence over 12 years. There was a significant increase in the proportion of children who were obese. This has huge implications for us in the future and for the health system. There are, of course, high personal and economic costs associated with this increasing incidence. So I was very pleased that it was decided that a report should be produced, looking at solutions right through to the design of urban development, where councils can play a role with exercise programs, community gardens and cooking classes—which I will mention a bit later.

This is something very close to my heart, and I gave evidence to the committee about my experiences—wrestling with weight since childhood, but going through the adult stages of life when one is doing a lot more activity, one gets through those issues. As one gets older, one is inclined to put on weight because of lifestyle, and not doing the exercise one used to do. Of course, there is also the downhill spiral which we can all get onto, and I think it is important that we do have knowledge to assist us.

I think recommendation 7 is very important. It asks the minister to put obesity on the Medicare Benefits Schedule as a chronic disease requiring individual management planning. This would make a huge difference to people struggling on their own to control their weight. I also think recommendation 9 is an important one. If adopted, the Commonwealth and states would develop a tiered model of health management, incorporating preventative community based primary care and acute care models. This is a bigger issue than just a medical model, and I think there needs to be a broader process in this area.

There are recommendations for tax incentives for fresh food, which is an interesting one, as well as for access to physical activity programs, especially for those in the bush. The member for Parkes was very articulate about that, noting that there is little opportunity for people in those areas to access the modern gyms and programs which people in cities and certain occupations have access to. I think that is important for those bush areas.

I have spoken before about the importance of urban planning and local government walking tracks. People will use walking tracks if there are signs on them saying how long they are. They feel safer about it and will utilise those tracks. We were talking earlier about how, in some of our low-socioeconomic areas, there are no footpaths for people to walk on. You have to walk on the road if you are going to go for a walk with your family and get that important exercise. Those are important issues that should be addressed and should be on the health agenda.

The other issue that I am very passionate about is swimming pools. Local governments usually run the other way, trying to get away from swimming pools. Bureaucrats in councils are always talking about the cost of swimming pools. Of course, there is no economic gain for councils from health budgets, so the states and Commonwealth should be looking at how to help create those very important opportunities for people, particularly young people, to use swimming pools. Pools should be connected to the broader health debate as a part of the solution.

It is important to understand food and the growth in easily available, cheap fast foods, which is an issue that is becoming more important and which has caused some of these problems as well. My colleague the member for Kingston spoke about the reduction of salt and fats in food. These are important issues—the eating of pure fat and salt and not much else. They are addictive and it is hard to give them up, just as it used to be with cigarettes. We are tackling a similar issue to smoking. We have achieved a lot in that area because we took it on as a nation, and a lot of people played a good part.

Also important are cooking classes, starting at school, to help children get curious about food and what they eat. Knowing what they eat, knowing what is in the food, having the opportunity and the knowledge to grow food, knowing what growing is all about and knowing what nutrition is in that food are all important parts of the future. I am very pleased that Stephanie Alexander’s School Gardens programs are underway. These issues are very important. Those programs are marvellous things and I hope many more opportunities will grow out of them. I have a daughter who is a chef and who is now training as a teacher, and she is very keen in this area. I am sure that she will make a very good contribution to the future of this area. Getting young people to appreciate gardening and growing things will change things.

We heard about the nag factor, getting kids going home talking about fresh food. There is a great opportunity to change how the nag factor usually works, when kids say, ‘Take me down to one of the fast food chains.’ Let us turn that around and have the nag factor working the other way. We can do that through good public education processes. Of course, making things fun and enjoyable is one of the important ways to do that.

I come to the situation, which is mentioned in the report on page 56, which deals with bariatric surgery and the issues around that. I have had that surgery and it achieved great results for me. The figures that I have seen indicate that this is a very successful way of helping people to significantly reduce their weight and the effects of type 2 diabetes. The figures point to significant drops in blood sugar levels. This assists in turning around type 2 diabetes results and in people getting management of their sugar levels. With a cost of around four or five thousand dollars, this surgery is a very cost-effective way of managing such problems, as opposed to the hundreds of thousands of dollars of costs associated with the ongoing problems of having diabetes.

As the report has recommended, I certainly believe in the need for a very tough criterion to limit how this surgery would be used but I believe it is one of the opportunities that we have to use another tool in the process. It does need to be done under a proper criterion, but the cost-effectiveness is very important here. Federal and state treasuries should look at this report as there are real important issues here about spending some money now on some of the recommendations because it will certainly help us reduce spending a lot more money in the future.

There is a need for planning with this surgery and for people to understand that it is only a tool. There is also a need to continue to change one’s lifestyle, to think about one’s food and to take on the physical opportunities that will help to continue to reduce health problems. As other people who have been involved in this report have said, there is no silver bullet. As the report has recommended, you have to take a whole range of measures to achieve these goals. We should use the tools available and we should look at these. Of course, an issue with this surgery is that it has been very difficult for people at the low end to get it. Most of this surgery has been done in the private sector, in private hospitals, and not very often in the public sector. We do need to turn that around and give people opportunities to use this tool to assist them in managing their health needs.

I understand that the figures that have been used state that the cost of obesity is $58 billion in Australia. I think that is probably underdone. There are the ongoing costs of other complications that come out of some of the diseases that latch onto obesity. Through my conversations with the medical profession and the knowledge that I have gained, that could be a very conservative number. I think there is so much more that we need to do. The report gives us a great opportunity to pursue those. In starting with the kids and getting them to understand more about food, nutrition and eating fresh foods, I think there is are great opportunities here for industry. In the way that we present food and fruit, there is lot more that can be done in the marketing of fresh foods. That needs to be given much more time and consideration.

In relation to labelling, I have always found that there is a difficulty in using the knowledge you get from a GP or a dietician when you are in a supermarket looking at a label. There is not much of a relationship. There needs to be a lot more done in the area of what comes out of a GP’s surgery and what comes out of a dietitian’s recommendations as related to what somebody gains from a food label. I think we are underdone in that area. I am sure there is a lot of self interest in that area that is protected. We should be putting the public health first, knocking over some of that self interest and getting to where we can actually provide the right information for people who need it.

Paul Neville (Hinkler, National Party) Share this | Link to this | Hansard source

I do not think you and I have been looking at it that well.

Dick Adams (Lyons, Australian Labor Party) Share this | Link to this | Hansard source

We can in the future and we can talk about these things, member for Hinkler. I am sure that somebody coming from a seat that has a fair bit of sugar growing would need to make sure that one is giving some consideration to the future of that industry and whether they make ethanol out of it or whether we are still putting it on our cornflakes.

There are a whole lot of issues—including urban planning and educating young people for all of us to take on more fresh foods—and recommendations in this report which show us the importance of the committee system of the House. This report can play a significant role in helping make policy into the future. I congratulate all those members of it particularly Steve Georganas as the chair and Mr Irons as the deputy.

Jill Hall (Shortland, Australian Labor Party) Share this | Link to this | Hansard source

This is quite a landmark report. I think it is a report that has only taken the format it has because of the enormous contribution by the secretariat. I would like to put on record my thanks to the secretariat for the work that they have done in relation to this report. They have been very dedicated in following up on the issues that we as a committee have raised and also been absolutely committed to the task of putting together the report that I believe is an excellent report.

Obesity is a problem that is confronting our society and most developed societies throughout the world. In some ways the more affluent a society is the greater the number of people who suffer from obesity. If you live in a developing country you are much less likely to be obese than if you live in Australia, the United States or the UK. It is interesting to note that when we were receiving evidence in the committee there were a number of people who came along and gave evidence who had suffered from a weight problem for a very long time. They had tried numerous approaches to lose weight, to get their body mass index into the normal range, and had failed on numerous occasions. I think the reasons for this are extremely complex. I also believe that it is important that much more research is done in this area.

I do not think there is any person not aware of the fact that they can address their weight issue by eating less and exercising more. I think everybody is aware of that. Yet, even with the knowledge and the ability to make that change, things have not changed. To me this is a very complex societal issue. It takes in enormous psychosocial issues. It is also interesting to put on the record at the commencement of my contribution to this debate the fact that there are socioeconomic factors involved with obesity and being overweight. I think the psychosocial factors have been underestimated in relation to obesity. I think that these factors need to be addressed in any lasting solution to this problem.

Childhood obesity starts basically from the time of birth. Someone with fewer resources is less likely to breastfeed their baby. It is a known fact—and this is covered by every bit of research that has been taken—that breastfeeding provides the ground for a child’s nutritional lifestyle and those who are breastfed do much better in the fight against obesity. The propensity for a child to develop obesity can start basically from the time they are born.

The media hype around the report related to bariatric surgery. That was just one recommendation in the report. A second recommendation that related to that was that a national register of bariatric surgery be established. I think the two need to be put together. It is important that bariatric surgery is available to people who do not have the same financial ability to access it as those who are accessing it at the moment. It is also very important that a register be developed because from the register the effectiveness of the surgery can be observed.

Bariatric surgery on its own is not the answer. Once again I am touching on the psychosocial factors that I mentioned at the commencement of my contribution to this debate. A person needs to have support all the way through the process. They need to have access to a multidisciplinary team to ensure they get the backup and the support that will ensure that they succeed.

Probably the most important thing in addressing obesity is that we have a whole-of-government approach to the issue—an approach that goes across each and every level of government and that encompasses the community. The only way we can successfully deal with this epidemic that is increasing our health costs and so many other costs within our community is for everybody to work together. To some extent this has taken place already. The national Preventative Health Taskforce has been looking at obesity. The government has identified three key areas in preventative health that it wants to address—tobacco, alcohol and obesity.

It is so important that we all work together on this. We need better research. We need research that gets to the core of why obesity is so prevalent in our society. We need to make sure that programs such as the Active After-school Communities program are retained, but extended. I touched on obesity from the point of view of breastfeeding and the importance of that baseline, but the committee was able to visit a number of excellent programs that targeted children. If a child develops the right exercise, eating patterns—like the Stephanie Alexander school garden program and other programs that target young people—and the right approach to healthy eating and healthy lifestyle then as they grow older the problem will dissipate.

The committee believes very strongly that general practitioners play a very important role in the area of counselling and referral for their patients who are suffering from obesity. It was felt that the government needs to include them very much in any sort of consultation and planning to address this important issue. There were some standout issues, issues that we were approached on by a number of people who came and gave evidence to the committee—and there were different perspectives on each of these. There was labelling, and we were lobbied very strongly to put in place a traffic light system. It was also proposed that food be labelled with the daily intake system. The committee believed that it was important that the Food Standards Australia New Zealand food labelling review all the issues relating to guidelines and that we have a uniform guideline placed on food so that people can make an informed choice. Labelling is a big issue. I do not know about other members, but whenever I go shopping I spend a lot of time looking at those labels and trying to find out what food is going to be the best.

Advertising was another issue we received quite a bit of information on. I thought the information there was most interesting. We had people from the advertising industry come along and say that advertising does not in any way affect children’s behaviour or desire to eat fast foods or high-fat foods. They argued that there were studies that supported advertising not encouraging people to go down that track. We had other health professionals saying that advertising was an issue that did impact on the choices that children made. The committee came up with a recommendation that we have got this conflicting information and we feel that it needs to be investigated. It needs to be investigated whether the billions of dollars that advertisers spend on targeting children to purchase various foods is worthwhile or whether there should be some limitation placed on advertising directed at children.

The whole industry that has developed around weight loss needs some regulation. I believe that there are so many claims being made by different people that it needs to be standardised and looked at so that you know that the information being presented is correct, and the committee made some recommendations about that. Recommendation 17 urged that we review the adequacy of the regulations governing weight loss products and programs. I think that is very important because so many people see an advertisement and then become involved in a particular program, or buy a particular product, but quite often there is no research to back up that advertisement. I think that really needs to be looked at.

The other issue I would like to spend a little time on concerns planning. Planning is an area in which local government plays an important role. Planning the way we build our towns and our cities is extremely important. Urban design over the years has quite often led to an environment that works against a person being able to undertake physical activity. I think that all levels of government are much more aware now that we need to be mindful of creating a built environment that encourages people to exercise. I think that guidelines in relation to creating a built environment that is conducive to exercise are very important. Local government should be quite mindful of that need when they are putting together their plans for sporting facilities and bike tracks and the access to those facilities.

This is an outstanding report. I think this is an exceptionally important issue for our society. If we do not act to end obesity now, the next generation of Australians will be dying earlier and will be sicker than the current generation. I recommend the report to the House.

Debate (on motion by Mr Craig Thomson) adjourned.