Belinda Neal (Robertson, Australian Labor Party) Share this | Link to this | Hansard source

I rise to conclude my remarks on the Australian National Preventive Health Agency Bill 2009. Accordingly, the national partnership agreement on preventive health provided $872 million to reform how the Commonwealth and states work together on preventive health. This agreement represents the largest single investment in health promotion in Australia’s history. Prevention forms the foundation of the Rudd Labor government’s approach to health care. I am very heartened to know that the health professionals on the Central Coast have already endorsed the Rudd Labor government’s new approach to a coordinated national strategy for preventive health.

In September 2009, Dr Phil Godden, the Chair of the Central Coast Division of General Practice, said ‘increased efforts in preventive health will result in fewer chronic illnesses, less pressure on hospitals and a healthier community’. Dr Godden also said that Central Coast GPs work with their patients every day in matters of prevention of chronic illnesses, especially obesity, smoking and alcohol. These are the three areas that we are specifically targeting with the National Preventive Health Strategy. The division is already running a number of programs supporting GPs in their preventive health roles. These include a lifestyle modification program that is run in conjunction with accredited physiotherapists and that aims to proactively prevent type 2 diabetes through a GP-monitored exercise program.

The Rudd Labor government is in total agreement with Dr Godden when he states that ‘it is self-evident that prevention is better than cure’. Dr Godden concludes by urging the government ‘to act on the findings of the strategy and begin implementation of it as soon as possible, as the longer it takes to start, the worse the health outcomes will be for those Australians who are most in need’.

I can assure Dr Godden and the rest of the Central Coast GPs that this government is acting both decisively and quickly on a national strategy for preventive health. The establishment of the Australian National Preventive Health Agency represents a bold new initiative in public health in Australia. It will boost Australia’s capacity to combat preventable diseases and set the nation up for a healthier and more prosperous future. I commend the bill to the House.

Bernie Ripoll (Oxley, Australian Labor Party) Share this | Link to this | Hansard source

I thank the House for this opportunity to speak on the Australian National Preventive Health Agency Bill 2009. Fortunately for me, I happen to be a board member of the Inala Primary Care facility in my electorate of Oxley. It is a community role that I have undertaken in an honorary capacity because I felt that this was one area of health care that was desperately needed and could be better managed in the overall construct in the way health services are provided in this country.

If there is one thing that we know after many years of study and many years of experience and learning in the health sector it is that preventive health care is the best health measure that we could possibly provide. Combining information from across the sector into a substantial health policy and providing that to all areas is, I think, the best approach. I am more than happy and more than satisfied to say that this is the approach that the Australian government, the Rudd government, has actually taken. We will certainly see that as part of the bill that is before us today.

My experience of preventive health care and primary health care in my local community has shown me that the benefits they provide to a community are enormous. The Inala Primary Care facility, which is right in the heart of my electorate, is an amazing organisation. It has developed out of a need in the community and it demonstrates just what can be done by a community when it has the right partnerships in health services. It was a struggling organisation that was having financial and, I think, service delivery difficulties. With its reorganisation—the establishment of a new board, a new system put in place and an approach that looks at how preventive health can benefit the community directly—we have seen an amazing outcome. There have been not only health outcomes but also economic and financial outcomes, which provide for the taxpayer as well as the health consumer.

May I say—and it is a great opportunity to do so—that the Inala Primary Care facility has won a number of accolades in the last two years. In particular, it has just won an award for the best preventative healthcare provider in Queensland. It is in partnership with the University of Queensland and with the state government department of health and really in partnership to with the private sector through GP services and through the people who actually run the organisation. I want to make particular mention too of Cathy Brown, the CEO, who is an incredible person. She has done some great work over many, many years and has brought an enormous amount of energy, experience and talent to the board and to the organisation, which has been able to provide fantastic service to the local community.

I think that it is one of those areas where we can do the most good in many cases. For too long health care has always been at the wrong end of health provision—that is, after the event. If we look at the great issues of health care today—obesity, diabetes, chronic diseases such as liver diseases and lung diseases, cancer and a whole range of other areas—we can see that if we can take some early preventative measures we can actually have a positive impact for the individual, which in the end is the most important person, but also for the community they live in and for taxpayers as a whole.

The communities in which we have seen the biggest impact are the Indigenous communities, and they are certainly a focus for Inala Primary Care. There are also other disadvantaged communities. It is not just about healthcare provision but also about education and about providing people with the right tools and knowledge to understand about lifestyle choices and about what they are actually doing themselves in order to get the right equipment so that they can be a major participant in their own long-term health care. Certainly there has been a lot of evidence of the good work done by Inala Primary Care and the long-term benefits that will be provided in that community.

Through a range of changes and policy directions that the Rudd government has taken we have been able to step forward in a number of directions when it comes to preventative health care and health care more broadly. It would have to be one of the most complex portfolios that any minister could take on, and I congratulate Minister Roxon on her fine work. It is one of the most complex portfolios—and I daresay that no-one on the other side in the opposition Liberal or National parties would disagree—but also one of those portfolios that needs almost a bottomless pit of money. There is no limit to what you could spend on healthcare provision. There is an understandable and expected standard in the Australian community that we are provided with the best healthcare services in the world. For the most part, that is actually the case. Our training, standards and requirements are world class; they are world’s best practice. The amount of equipment and services and the types of resources that are provided are first class and world’s best practice. Also, through the Medicare system we have a universally accessible system that is affordable. Those different pillars within the health portfolio provide all Australians with an incredibly great service, one that does not discriminate on locality as such, on your income level, on who you are as a person or on what community you live in.

In saying that, I do acknowledge that there are some limitations. Where you live does have an impact on your ability to get certain services, and locality is one of the great challenges for all Australian governments in how they provide services. But certainly the work that we are doing and the cost-saving measures that we are bringing to the health portfolio, along with the enhancements through our GP superclinics in communities where they are desperately needed and a range of other policy initiatives, I think take us in the right direction.

I will sum up briefly by saying that having a preventative health framework, a preventative healthcare policy and legislation that does all that it can to provide the right instruments, tools and regulatory frameworks for the health sector to provide the best possible care and give people the tools necessary for them to look after themselves is the right way to go. It is a commendable approach by the Department of Health and Ageing. I commend the bill to the House and again congratulate the minister for health for her fine work.

Graham Perrett (Moreton, Australian Labor Party) Share this | Link to this | Hansard source

I too rise to speak in support of the Australian National Preventive Health Agency Bill 2009. My first inclination is to use the word ‘preventative’ rather than ‘preventive’, but people should not be too disturbed about it. I looked up the etymology of the words ‘preventive’ and ‘preventative’. It is from Middle English and, prior to that, from the Latin ‘praevenire’, meaning ‘to come before’, so it is much the same word. People can relax because there is no big difference at all.

The passing of the preventive health agency bill will bring about a new era in Australian health reform as we move on from talking about preventive health care to actually doing something about it. We have known for a long time that as a nation we must do better and do more to prevent chronic disease—from when the cartoon character ‘Norm’ was telling us to be more involved with life, back in the seventies. A former Queensland health minister, the Hon. Stephen Robertson, who was my boss, described it as ‘a tsunami of chronic disease coming our way’. The member for Oxley touched on that in his speech.

There are some pretty chilling facts out there. The first baby boomers will retire next year. I was born in 1966. According to some definitions, I am either the last of the baby boomers or a few years into Generation X. That whole wave of baby boomers is going to put incredible strains on our health system. As earlier speakers have indicated, we have a high expectation of healthcare needs in the Australian community. People are not prepared to lower those standards, and obviously no government wants to lower those standards. But the costs to our community are going to be astronomical if this tsunami of chronic disease does reach us.

I will take one example: obesity. It is estimated that the overall cost of obesity to Australian society and governments was $58.2 billion in 2008. Chronic diseases like diabetes, some cancers and heart disease loom large on the horizon for way too many Australians. But prevention, as they say, is better than cure. The other proverb is: ‘A stitch in time saves nine’. US studies have shown that every dollar we spend on preventative health saves us about $5 in health expenditure, so, to be more accurate, we could change the proverb to: ‘A stitch in time saves five’. When you consider the escalation of healthcare costs in recent years and the projections for the future, now more than ever, we need to, as Norm said, be a little bit more active. Not only can we save money but, more importantly, we can save lives, extend lives and improve people’s quality of life.

During the parliamentary recess I held two seniors forums in the northern and southern bits of my electorate. Because they were so successful, I then held a seniors health forum in Annerley. After the Sunnybank and Annerley seniors forums, people were so excited about the local Brisbane South Division of GPs that they wanted more information about some of their health concerns and what they could do. It was a golden opportunity for our senior citizens to meet local health practitioners, to find out more about how to keep fit and healthy and to give their feedback on our health system. The chilling bit was when one of the GPs from Sherwood talked about inoculations. Basically, all of the characteristics of the people who should be getting swine flu injections applied to me. I thought it was for other people, but it became clear that if you travel a bit, meet lots of people and shake hands you should receive a swine flu vaccination, which I will be taking steps to do. The message I heard loud and clear from our seniors at the three forums is that governments have to do more to promote healthy lifestyle choices and help people stay healthy and out of hospital. Prevention, as they say, is much better than cure. If we do not act now, we will be overwhelmed by this tsunami.

This bill sets up the Australian National Preventive Health Agency to drive research and investment in preventive health. The agency will report directly to the health minister and, through the Australian Health Ministers’ Conference, to ministers around the country. It is another initiative to come out of COAG and was agreed to in November last year as part of the National Partnership Agreement on Preventive Health. Again, the Rudd government is putting politics and turf wars aside in the interests of a better and healthier country.

In consultation with Australian health ministers, the health minister will appoint the CEO and an advisory council for the National Preventive Health Agency. The council will include Commonwealth, state and industry representatives, including experts in preventive health—the people at the coalface, so to speak, in terms of saving and changing lives. The agency will help support health ministers around the country achieve outcomes through the national partnership. This includes delivering about $700 million to help Australians adopt healthier lifestyles. The Commonwealth is providing $133 million over four years to establish the agency and fund preventive health research and social market campaigns that target issues like obesity and smoking. It is no secret that obesity and smoking are major causes of chronic disease but the messages are not yet getting through.

I remember when I was elected in November one of the first things that happened was that the ‘baby’ MPs were brought to Parliament House and were given a talk about the challenges of life in Canberra. The MP who gave us the talk spoke about putting on one kilo of weight a month. Thankfully I have not quite lived up to that; I think that would be 23 extra kilos. Looking at the other MPs who were at that talk, I do not see anyone that has done as bad as that. I am not sure that every MP can say the same thing. It was certainly an indication that you have to be very, very careful. Everywhere we go we get offered some food, and it is normally very tasty food but probably not the best food, and it is likely to put on a couple of extra kilos.

Similarly around 20 per cent of Australians still smoke. Regarding the overall numbers, the trend, is slightly downwards except, I was sad to see, amongst young women. The numbers of young women who are taking up smoking are actually increasing. With all of the knowledge that we have of cancer and carcinogens, there are still people who smoke. I know it is hard to believe, and some of them are informed people. We need to do what we can to get those trends down for young women and for Australians overall.

Obesity is projected to lower our children’s life expectancy by two years by the time they reach adulthood. That is an amazing statistic. My children are nine months old and four years old and to think that we are breeding a generation that is going to have a lower life expectancy than us is a suggestion that civilisation is not getting it right. Even my four-year-old knows many of the brands and the ads connected with fast food establishments—I am loath to call them restaurants. It is amazing how much more efficient some of these fast food agencies are compared to parenting advice. It is almost unbelievable to consider that the next generation could have a shorter life expectancy than us, their parents. As I said, it is almost an abdication of the term ‘civilisation’. But, and it is a big but, spelt b-u-t-t, we can turn this trend around.

The agency will focus on issues like healthy weight, physical activity, healthy eating and smoking to help drive the wholesale change in attitudes and behaviours. Of course, if our aims to reduce preventable chronic disease are to be achieved, we need cooperation across governments, across academia, through the media, through sporting bodies and through others. I think it is about time that the fast food industry stood up. I would certainly call on my local restaurants and fast food establishments to see what they can do. Rather than just having a token healthy food item on the menu, perhaps they could actually try and sell it rather than merely have it there as a token item that no-one buys.

The Preventive Health Agency will have a big role to play in fostering this cooperation across industry and the non-government and community sectors. Other key roles of the agency include providing evidence based advice to health ministers on preventive health issues; pulling together data on preventable chronic diseases and risk factors; providing research grants; and promoting national guidelines, standards and best practice codes for preventive health.

I have spoken about this before, but one of the most appalling legacies of the coalition government was their gross underfunding of the public healthcare system. Over the life of their government, they left state governments billions of dollars out of pocket on public health through the funding administered by the Australian healthcare agreement. In June 2007, state and territory health ministers released the report Caring for our health? A report card on the Australian government’s performance on health care. This report found that, around the nation, the coalition government were ripping off the public health system by about $1.1 billion every year. That equates to about 350,000 additional admissions each year. So starved of funding were our state health systems that there was very little left over to focus on the longer term preventive strategies to address the causes of chronic disease. You cannot worry about tomorrow or what is going to appear on the horizon when the ambulances are ramping outside the emergency services department.

In contrast, the Rudd government are facing up to our responsibility to improve the health system, and we are moving on a number of fronts through our health reform agenda and the national preventative health strategy. In cooperation with state and territory governments, this strategy sets bold targets to reverse obesity trends, halve smoking rates to below 10 per cent and reduce risky drinking levels. The new Australian National Preventive Health Agency will have a significant impact on the future of health care in Australia. All of us in this place want to see Australians healthier, and I am confident this new agency will provide the kind of support and advice that our health ministers need to achieve that. I commend the bill to the House.

Kerry Rea (Bonner, Australian Labor Party) Share this | Link to this | Hansard source

I too rise to support this very important Australian National Preventive Health Agency Bill 2009 before us today, because, as we all know, there is nothing more essential to all of us than good health. If you are suffering from some form of illness or injury, it just makes resolving all the other problems that you contend with in your daily life so much more difficult. So we all know that the best start to any day is to wake up feeling healthy. That can prepare you for whatever the day may bring—and we all know, particularly those of us in this job, that the day can bring anything other than that which we have planned! It is also important for a well-functioning and productive society that all individuals have good personal health and that we support the physical and mental health of all who make up that society and community.

Although these statements may be self-evident, unfortunately, as individuals and as a community our physical and mental wellbeing is not the highest priority at all. In fact, it is often the lowest priority. Whether it is work or family responsibilities or other commitments in our lives, they always seem to take precedence over taking care of ourselves during the day. As a result, often the only time that we ever really deal with our own physical wellbeing is when it is too late—when we are either ill or injured and we require medical attention and expertise. Rather than focusing on prevention, we wait until we get to the point of falling ill or hurting ourselves because we have not paid due attention to our health.

If we took the time to care for our minds and our bodies before they break down, we would find that not only the rest of our own lives would be easier but many of the social problems that we as a society face, and, of course, the enormous amount that we as a government and other levels of government spend on health care, would drop dramatically. We are not talking about a new-fangled idea here. We know that prevention works. There is enough evidence to show, as the member for Moreton said, that losing weight, getting fitter, stopping smoking and reducing or even giving up alcohol consumption make a big difference in preventing disease and improving our life expectancy. But, for some reason, a vast majority of us just do not take any notice.

But when we do take notice, when we see governments or community organisations embarking upon community awareness campaigns around a particular disease or some other form of injury and people do take notice, we know that prevention actually works. Whether it is the restrictions on tobacco advertising, which have seen a significant reduction in the number of people taking up smoking, whether it is the good old ‘Life. Be in it.’ campaign on television that we all remember, which got us up out of our chairs and our beds and got us walking and exercising, or whether it is something as simple as enforcing policies on the wearing of bike helmets, and what a significant reduction in head injuries and other injuries we have seen as a result of that small but very significant change, prevention works. There is the campaign around the wearing of seat belts and enforcing that policy. Indeed there are some very significant changes, particularly when we look at the campaigns on safe sex practices which have had such a significant impact on reducing the spread of HIV-AIDS in this country. All of these things clearly point to evidence that, when a good prevention campaign is run, people will take notice and it will have results. In fact, road trauma deaths have decreased by 80 per cent since the 1970s. There are probably a number of factors involved in that, but I think it indicates that the simple act of wearing a seatbelt and requiring all people to wear seatbelts in a car certainly has made a dramatic difference when it comes to road trauma, accidents and deaths.

For that reason, I am very pleased to see that the Rudd government, under the leadership of the Minister for Health and Ageing, Nicola Roxon, established the National Health Workforce Taskforce in 2008 and recently launched the National Preventative Health Strategy, in September this year. If we are serious about reforming the health system, and we know that we as members of the government were elected on that very clear commitment, if we are serious about implementing our commitment and our policies, we must start with prevention. We currently spend less than two per cent of the health budget on prevention measures and, as a result, we all know that the demand on our public health system, the reliance on GPs and the cost of, and reliance on, medication are increasing dramatically. But, of course, we could do a lot better if we were able to focus policies on prevention.

We know that this is not just about feeling better ourselves. We all know the personal cost of being unwell, whether we just feel bad or have hurt ourselves. We know the social cost of being unwell and the impact it has on us both socially and economically. Whether it is the loss of work time or the loss of income, not only does that impact on the sufferer but also it clearly impacts on the family and the people they are dependent on. It also has a significant impact on general productivity. So this is not just about making us feel good. It is about saving the dollars that we spend through taxation support on the health system and about improving the economy through increased productivity.

That is why the role of the preventative health agency is so critical and why I am so pleased to see this legislation before the House, because the government’s goal of reforming and improving our health system cannot occur without it. The health agency will be established as a statutory authority under the Financial Management and Accountability Act. It will be established as a result of the National Partnership Agreement on Preventative Health between the state and Commonwealth governments, which was agreed to in November 2008. Once again we see not only that this is an important initiative for health but also that it demonstrates this government’s constant argument that, when governments at all levels work together rather than in competition with each other, the community and all of us as individuals benefit.

The Commonwealth will provide the agency with funding over four years of $133.2 million. This includes $17.6 million for set-up and maintenance of the agency, $102 million for national social marketing campaigns around smoking and obesity—two areas where we know prevention can significantly reduce the onset of a vast number of diseases, particularly in later life—$13.1 million for research to inform policy development around preventive health and $500,000 for an audit of the preventive health workforce. As you can see, this is a significant commitment. We acknowledge that, if we are to be serious about preventive health, if we are to put our money where our mouths are, it needs to be serious funding and clearly this legislation indicates that. Marketing and awareness campaigns will be funded, as will research around measures that will help us to develop better and more informed policies around preventive health for the future.

I think that the most critical role of this agency will be that of coordination. The failure in the past to get the message across to members of the Australian community has not just been because there has been a lack of activity in this particular area; I suspect it is also because there has been a lack of coordination and cohesion, which has prevented a clear focus on the policies that can work when it comes to preventive health. The agency will provide leadership, coordination and monitoring to support the successful implementation of the initiatives that will be funded through the national partnership on prevention, and it will include $692 million for interventions to help Australians modify their lifestyles. As we know, $692 million is not an insignificant amount and I suspect that the investment in intervening in people’s activities and encouraging them to change their lifestyles will save much, much more than that in the long term. It will mean we are not required to spend that amount of money on treatment those people would require if they had not done anything about changing their behaviour.

The coordination is important when you consider the diverse number of organisations, individuals and industries that already exist around preventive health, such as health and fitness operators from gym owners through to personal trainers; private health insurers; sporting clubs and associations; health professionals; allied health professionals and alternative medical people such as naturopaths, osteopaths and the like. When you consider the range of people trying to do their bit in this area, I think we can all appreciate the incredibly powerful impact that would occur in the community if there was an agency that brought together all of the good work those people are doing. The agency could start to coordinate and focus on how combined efforts could do more in the area of prevention of illnesses and injuries.

The agency will be a significant government body and will therefore need to be accountable to the taxpayers who fund it. It will produce triennial strategic plans and an annual operational plan that must be approved by state and federal health ministers. The minister will appoint a CEO to the agency. There will also be an advisory council that will consist not only of the key government bodies—state, territory and Commonwealth governments—but also representatives and individuals with expertise in this area. So, once again, we will see a significant step towards being serious about preventive health by having an agency that incorporates not just the funding bodies but the people who are doing the work on the ground, that knows what works and can not just inform existing programs but help us to better develop future policies.

I think it is important that we do acknowledge the role of all levels of government in this. Coming from a local government background, I certainly appreciate the role that all governments play. Indeed, I believe that local governments are key in the preventative health strategy of this country. It is local governments that provide the parks, recreational activities, the physical spaces and the sporting and recreational programs at a local level which encourage people to get out of their houses and be more active. Whether it is simply a festival that means you do not sit and watch videos on your TV but you walk outside and listen to some local music, whether it is a kite-flying day or whether it is providing bike paths—all of that physical and social infrastructure, which does not get acknowledged as a key part of the health budget in this country, is now being brought to the table with other levels of government and acknowledged as playing a key role in preventing illness and improving the health of all in our communities.

The council will also focus on a couple of very key issues when it comes to developing policy and working towards improving the health of our citizens. Social marketing is a term not usually equated with health policy, but, as I demonstrated earlier with the number of significant community and government awareness-raising programs in this country, it is clearly a very important part of the health policy in the health budget because it is the way that you get the message out to people. It is the way that you encourage people to take some responsibility for their own wellbeing and to understand that it is not selfish, ignorant or negligent to take time out each day to care about yourself. You need to care about yourself and make sure you are functioning in a well and satisfied way. The people who depend on you—your work colleagues, family, children and friends and people in organisations that you are involved in—will benefit from you taking care of yourself. That is a very important message that we need to get out there.

It is also why I think that this agency will work, particularly through the advisory council. This is not just a top-down approach; it is acknowledging the significant investment in dollars but it is doing so by saying that we have to form partnerships with not just the people who are working in this industry but the people who are benefiting from the industry. We need to encourage individuals and community organisations, as well as those providing the services to them, to be part of this program. You need to take responsibility for yourself. The government will invest in your health if you partake of those activities that will ensure a longer and healthier life.

In the last few minutes I have got I want to talk about the local consultations I have been having in my electorate of Bonner. They have mainly been around the Health and Hospitals Reform Commission report. Three messages came out of the discussions and consultations I have had with people about how we deal with the already fairly pressured health system: prevention, prevention, prevention. The health professionals are saying that we need more money put into prevention—‘Let’s get that graph of funding better. We don’t want less than two per cent spent on preventative health care and such an enormous amount spent on acute health care. We want to reverse that trend. We need to invest more in preventative health policies.’

I would like to pay tribute to Tyack Health in my electorate. It is a family run business that for 40 years has been doing just this. This group of doctors understand not just the significance of having a good supply of bandages and injections but the importance of preventive health care. They started doing it 40 years ago. They now have a massive medical centre on Radford Road in Manly West. They have pilates teachers, chiropractors, GPs, physiotherapists, nutritionists, dieticians and massage therapists all under the one roof. When someone rings to access any of those services the first thing that is done is an overall health check to find everything that may be affecting them.

The professionals at the Tyack Health Centre understand that people do not always see the symptoms of a potentially life-threatening disease and that intervention is sometimes needed. They also appreciate that treating one symptom that a person has can often have an impact on everything else associated with their personal wellbeing. So a holistic approach to health care achieves great results when it comes to prevention. Obviously, it also means that we see great results in terms of the cost of health care in this country.

On a final note, when I was researching for this speech I referenced a very interesting media release put out by the Minister for Agriculture, Fisheries and Forestry, the Hon. Tony Burke, who often does not get mentioned in health debates, but I think his press release is worth mentioning. The press release talks about the research that was done on the health benefits of Australian native food. Indeed, when you look at things like the Kakadu plum and the Australian desert lime, you find that they have incredibly high levels of vitamin C. The bush tomato, the Tasmanian pepper leaf and wattle seeds were found to contain the richest sources of iron amongst all the herbs and spices tested. The Kakadu plum is also rich in antioxidants, which all of us who are very concerned about our skin would know is of great benefit.

It is well worth looking at what is literally in our own backyard. It reinforces once again that we should pay tribute to being in a country which is home to the longest living, longest running civilisation on this planet, the Aboriginal people of Australia. Perhaps it was the wattle seeds, the quandongs and the Kakadu plums that have contributed to such a vibrant, interesting and wonderful culture still being with us today. I think we know that there are many lessons to be learnt from the fact that Indigenous people have cared for this land and for themselves and their families for so many thousands of years. (Time expired)

Shayne Neumann (Blair, Australian Labor Party) Share this | Link to this | Hansard source

Less than two per cent of health expenditure is spent on preventive health. That is the legacy of the Howard coalition government after 11½ years. We are about to change that, because preventive health works. The federal government has brought forward a number of reports. There is the final report of the National Health and Hospitals Reform Commission, which was released on 27 July 2009, and also two other significant reports, including Building a 21st century primary health care system: a draft of Australia’s first national primary health care strategy.

The report that is particularly germane to the Australian National Preventive Health Agency Bill 2009 was prepared by the national Preventative Health Taskforce, chaired by Professor Rob Moodie, and is entitled Australia: the healthiest country by 2020: National Preventative Health Strategy—the roadmap for action. Professor Robert Bush from the Ipswich Campus of the University of Queensland was also a participant in that strategy. I was pleased that he, amongst other people, was present at the Ipswich and West Moreton health forum hosted at the Ipswich Campus of the University of Queensland on 8 October this year. I want to pay tribute to the many people who turned up to that forum: the Division of General Practice, many doctors, Ipswich General Hospital, the Queensland Department of Communities and, of course, the University of Queensland, which has engaged in a significant health study, including the Ipswich study. I want to thank Professor Alan Rix, the Pro-Vice-Chancellor of the University of Queensland. But the driving force, along with me, was Professor Helen Chenery, who was actively involved in the promotion of the health forum.

As the member for Bonner said, the message is loud and clear. People are interested in this issue and in what we are doing both nationally and locally when it comes to preventative health. I was very interested to read the press release from the University of Melbourne; of course, that is where Professor Moodie comes from. It is from September 2009 and relates to the 307-page report, which had a broad range of recommendations to be implemented in three stages until 2020. They are all focused on reducing the burden of obesity and alcohol and tobacco consumption on Australia’s health and wellbeing for young people and our more senior citizens. We know from the study that these three risk factors cost us in the order of $6 billion per year, and we know that productivity loss is estimated at $13 billion annually by reason of the scourge of obesity, excessive alcohol consumption and the simple use of tobacco. The first National Preventative Health Strategy gives us what has been described by Professor Moodie as a road map of guidelines to address these significant health issues.

We in this country pride ourselves on our champions. We are terrific when it comes to sport for a country of 22 million people. Our Olympic record is fantastic. We are very good when it comes to sports such as netball, hockey, basketball, rugby league and rugby union. Our recent performances in men’s and women’s soccer are to be applauded as well. But it comes to the question of what we do in our classrooms, schools, kindergartens, preschools and homes. That is the big and problematic issue. What we do in our family life really affects the long-term health, prosperity and wellbeing of our people.

The Rudd Labor government is strongly committed to recognising that prevention is better than cure, and we are working closely with the states. The Institute of Health and Welfare recently came out with its press release of 30 September 2009, relating to a study that showed that the Rudd Labor government is correcting the past failures of the Howard government with respect to health issues. The Australian government’s share of public hospital funding was 42.5 per cent in 1997-98. It plummeted to 38.6 per cent in 2006-07 and under the Rudd Labor government it has risen again to 39.2 per cent.

But what we spend on our hospitals is really going to curing the disease or illness. The national health and hospitals strategy put forward a very serious problem in terms not just of the health and welfare of our people but of the economic development and future prosperity of our country. In 2003 in this country we spent—this is what the Institute of Health and Welfare says—$84 billion on health and aged care. It is projected that by 2033 we will spend $246 billion, or 12.4 per cent of our GDP. That is simply unsustainable. We really need to look at what we do with respect to preventative health. We need to keep our people fit, healthy and out of hospital.

We know that, as Benjamin Franklin said, there are only two certainties in life—death and taxes—and we know that all of us will pass away at some stage, but what we need to do is enjoy an abundant, full, happy and healthy life as best we possibly can. The government’s commitment to preventative health is demonstrated not only by the legislation before the House but also by the record amount spent on preventative health, $872 million. We are doing that through the COAG process in partnership with the states and territories.

So we are trying to keep people fit. We are providing health checks for four-year-olds to promote early detection of chronic disease factors. We are spending $12.8 million to fund 190 schools around the country to construct either a kitchen or a garden under the Stephanie Alexander Kitchen Garden National Program. There are a whole raft of reforms we are undertaking. But it is the recommendations with respect to obesity, tobacco and alcohol that, if implemented, I believe will make the greatest change to the health and welfare of this country, because these things affect every family and every community and, when tackling primary health care, we need to focus on preventive health measures.

The member for Bonner mentioned in detail the funding provision under this legislation. We are providing $133.2 million over four years for the Australian National Preventive Health Agency. That is a lot of money, and that is a demonstration of the seriousness of the government’s commitment in this area. As the member for Bonner outlined, of this money, only $17.6 million is for the establishment and maintenance of the agency. We are putting $102 million into the national level social marketing campaigns targeting obesity and smoking.

It is sad to see that in a lot of other countries around the world smoking is an addiction and an obsession. Many countries have smoking rates at 40 and 50 per cent of the adult population. In this country, we have had a targeted strategy for smoking and we have seen a clear reduction in the per capita consumption of tobacco. The Minister for Health and Ageing, in her second reading speech on 10 September, pointed out some very interesting facts in this regard, and they are worth repeating:

Between 1950 and 2008, more than 900,000 Australians died because they smoked …

That is notwithstanding the fact that it was known from the middle of last century that smoking tobacco had clear risks to people’s health. The strategies that we have undertaken have seen a reduction in smoking. We have seen a reduction in the number of young people taking up the habit. The Australian public is more aware than ever of the perils of smoking. The average person on the street knows that smoking is a danger and that, if they smoke, not only their lifestyle but their life expectancy are affected and they risk a premature death. As the minister said:

The Preventative Health Taskforce set a target of reducing smoking rates to less than 10 per cent.

What a great target. If we can achieve that:

This would mean approximately one million fewer smokers in Australia, and according to the taskforce—

And this should really resonate with everyone—

would prevent the premature deaths of almost 300,000 Australians.

The government are also undertaking a big information campaign about the dangers of excessive alcohol consumption, particularly among young people. Certainly, the schools in my electorate have seen assistance with ‘mystery tour’ funding, which ensures that when young people have their school formal they do not engage in binge drinking but rather in alternative, enjoyable, healthy physical activity where they are not in danger of assault or misbehaviour or vulnerable to any other form of risk. I commend people like Tanya McKenna, a teacher at Ipswich State High School, for the program that is now being duplicated at schools like Bremer State High School and Redbank Plains State High School, and I commend the government for the funding they have provided to Ipswich State High School in this regard.

As a bit of a sports tragic and also as a bit of a Brisbane Bronco supporter, I look forward to the day when my beloved Brisbane Broncos do not have alcohol advertising around Lang Park. I look forward to that day because, just as the abolition of smoking advertising on TV had an impact on young people and our community generally, I think that if we were to undertake that strategy, if we were to change the culture and phase out alcohol promotions and advertising to our young people, as is recommended in the strategy, it would change the drinking culture in our community. I think we can do better with respect to advertising. I think we can ensure our young people are not put at risk. As the parent of an 18-year-old daughter and a 20-year-old daughter, I am very concerned about what I see amongst young people in my community with respect to excessive consumption of alcohol.

But the member for Bonner was absolutely correct when she talked about the role of local government. That is what came through in the health and hospitals forum we had for the Ipswich and West Moreton area at the University of Queensland. One thing that came through very clearly was the role that community infrastructure could play, and that is why the federal government’s commitment with respect to community infrastructure is so important. The Ipswich City Council, the Lockyer Valley Regional Council, the Scenic Rim Regional Council and the Somerset Regional Council—all in my area west of Ipswich and the Ipswich City Council—have undertaken to use that Community Infrastructure Fund in a way which helps the health and welfare of the community. For instance, to the credit of the Scenic Rim Regional Council, they have used $480,000 of that federal money for the Scenic Rim health and hydrotherapy complex.

The Ipswich City Council has used that money across the whole area—from the rural parts all the way down to Springfield—for funding for parks, toilet facilities in those parks, beautification of those parks, bike trails and the like, and they have used $10 million of federal government money for the Springfield parklands, which will make a huge difference. It will be like Central Park in Ipswich. That is how much it will be used by the people of Ipswich in those rural areas.

Local government has a big role to play because what it can do is enormously important. For example, there are parts of my community in Ipswich where there are great bikeways all over the place. You see people out there walking, riding their bikes, jogging, with the dog, getting active and getting healthy. They are not being Norm; they are being healthy. That is the difference local government can make. So our strategy—in terms of not just our agency strategy under this legislation but also our strategy undertaken with respect to the Community Infrastructure Program rollout—is playing an important role in helping the health and welfare of this country as well. It is partnering with local government, making an impact on people’s lives locally.

I think that we can do a lot more in this country. I think we can achieve what we hope to achieve by 2020. I think we can reduce the obesity rates. I think we can reduce the excessive consumption of alcohol. I think we can stamp out the practice of so many young people consuming and taking up the vicious and wicked habit of tobacco consumption. I think we can make a big difference. I am one of those people with a belief that governments can make a difference in people’s lives. I have seen it in my personal life and I have seen it in the lives of the people who live in my community. I think this legislation is one of the most important pieces of legislation we have ever passed in this House. I think that it is going to make a huge difference in every community across the country. I am so happy that we have taken this initiative. I think it is long overdue, and it is really to the discredit of the opposition that when they occupied the treasury bench they did not have the wit or wisdom to do what we are doing now. If they had done that, how many more people would live happy and healthy lives, lives of activity, lives of sport, and lives of abundance. I commend the legislation to the House.

Yvette D'Ath (Petrie, Australian Labor Party) Share this | Link to this | Hansard source

It is my pleasure to rise to speak in support of the Australian National Preventive Health Agency Bill 2009. This is certainly a step forward in the Rudd government’s commitment to health and hospital reform throughout this country. It is more than just a step forward; it is a historic step. It is the first time in this country that we will have a dedicated organisation to help combat the complex challenges of preventable, chronic disease. This bill establishes the Australian National Preventative Health Agency, an agency to support the Australian Health Ministers Conference and, through the ministerial conference, the Council of Australian Governments in addressing the increasingly complex challenges associated with preventing chronic disease in our community.

This agency will be established under the auspices of the National Partnership Agreement on Preventative Health, which was announced through COAG in 2008. It is through this national partnership that the government has already committed to providing $872.1 million over six years for a range of initiatives targeting the lifestyle risk factors of chronic disease. These include settings based interventions in our preschools, our schools, our workplaces and our communities to support behavioural changes in the social context of everyday lives. These will focus on poor nutrition, physical inactivity, smoking and excessive alcohol consumption, including binge drinking. It will also address social marketing aimed at obesity, tobacco and enabling infrastructure to monitor and evaluate progress made by these interventions, including the Australian National Preventative Health Agency.

This new agency will have a very important role in providing evidence based advice and national leadership and stewardship through data collection in order to ensure that we improve the availability and comparability of evidence. It is important that we have this national coordination in providing evidence based advice to the minister and the government as a whole as they try to tackle this issue that we face in relation to chronic disease. The agency will also support behavioural change through education or promotion and community awareness programs relating to preventative health. I will talk in more detail shortly about how important those educational and promotional activities are in the community and how important it is to lift awareness and education. This agency will also have a role in supporting and facilitating partnerships with relevant groups; and promulgating national standards and codes to guide preventative health initiatives, interventions and activities. Of the total cost of the measures enabled under this bill, $133.2 million over four years, $102 million is allocated to national-level social marketing campaigns targeting obesity and smoking. Another $13.1 million will go to a preventative health research fund.

Any focus on preventative health is welcome not just at the government level but by our health professionals in our local communities. In my electorate, local GPs, physicians and allied health professionals have been calling for a national focus on preventative health and for funding commitments to reflect this focus. I am excited at the acknowledgement of the Minister for Health and Ageing, the Hon. Nicola Roxon, that preventative health is a policy area that the government has given the highest priority. We all know that by focusing on preventative health significant benefits can be achieved. Those savings, of course, are not limited to financial savings. By working towards a healthy nation we will help improve people’s quality of life, the quality of life of their families and their ability to productively be part of society and to relieve the burden on the social services in our communities that deal with chronic disease. As the saying goes, prevention is certainly better than the cure.

This brings me to some of the more commonly known preventable chronic diseases. Prevention has been defined by the World Health Organisation as:

… approaches and activities aimed at reducing the likelihood that a disease or disorder will affect an individual, interrupting or slowing the progress of the disorder or reducing disability.

Early intervention and treatment can result in complete recovery, remission or a long and improved quality of life than otherwise would have occurred if preventative measures had not been taken.

There are a number of common preventable chronic diseases, and some wonderful initiatives that have already been undertaken in our local communities, in our states and across the country. Diabetes is one example. In Petrie alone there are 4,791 people with type 2 diabetes. Of all of the people with diabetes in my electorate, 84.41 per cent of those people are type 2. This is above the national average. There are 1,657 people in Petrie with diabetes who need insulin. Type 2 diabetes affects 85 to 90 per cent of all people with diabetes. While it usually affects mature adults, more and more young people, even children, are getting type 2 diabetes. Type 2 diabetes is a lifestyle disease and is strongly associated with high blood pressure, high cholesterol and extra weight around the waist. Across the globe the statistics are even more daunting: every 10 seconds a person dies from a diabetes related cause, every 10 seconds two people develop diabetes, every year a further seven million people develop diabetes. Diabetes is the fourth leading cause of global death by disease.

I mentioned earlier that there are some preventative measures that are already being taken by governments and organisations both nationally and globally to tackle these diseases. World Diabetes Day is celebrated worldwide and is coming up on 14 November. It involves more than 160 countries. Millions of people are engaged to take part in diabetes advocacy and awareness. This year, 2009, is the beginning of a five-year campaign to address the growing need for diabetes education and preventative programs. The campaign slogan is ‘understand diabetes, take control’. World Diabetes Day is also a major fundraiser for Diabetes Australia Queensland, and helps raise awareness about diabetes. Funds are used to educate the public about the risks associated with diabetes and to support people, families and carers living with diabetes.

Diabetes associations and Diabetes Australia have established a website. I attended the launch last year. This new website allows individuals to not only gain information about what are the risks associated with diabetes and what can be done to avoid getting diabetes but also gain more education about type 2 and type 1 diabetes and what are the types of treatment. It also provides an amazing tool for individuals who have diabetes, where they can put in their local suburb or postcode and it will come up with a map, a bit like a Google map, which identifies medical providers and pharmacists in the area who provide the equipment that they need. This is a great new tool to help people manage their condition. Prevention is not just about stopping the disease occurring in the first place; once someone has the disease, it is about managing the disease in a better way so that those people have a better quality of life overall.

Heart disease is another chronic disease that is preventable, yet many Australians are still quite ignorant about the risks that they face. Cardiovascular disease is heart, stroke and blood vessel disease. It kills one Australian nearly every 10 minutes. It affects more than 3.7 million Australians. It prevents 1.4 million people from living a full life because of disability caused by the disease. Cardiovascular disease affects one in five Australians and affects two out of three families. It has claimed the lives of almost 46,000 Australians—34 per cent of all deaths in 2006—despite the disease being largely preventable. Females are particularly at risk of this disease and I think we are quite ignorant of that fact. Madam Deputy Speaker, I seek leave to continue my remarks at a later stage.

Leave granted.

Debate adjourned.