Andrew Southcott (Boothby, Liberal Party) Share this | Link to this | Hansard source

Making sure that our health system is set up to provide quality chronic disease management is one of our great challenges. I have previously spoken about integrated health checks, a health policy which I believe would be very beneficial to our health system. This check would help encourage preventive health, recognising the interaction between diseases and their risk factors and helping to support best practice guidelines. It would involve a diabetes assessment, a kidney check and an absolute cardiovascular risk assessment in general practice.

The Australian Institute of Health and Welfare has identified chronic disease as Australia's greatest health challenge. Chronic disease—mainly coronary heart disease, stroke and heart failure, chronic kidney disease, cancer, lung disease and type 2 diabetes—is responsible for 90 per cent of all deaths in Australia, and 85 per cent of the total burden of disease. There are strong relationships and shared risk factors across heart disease, stroke, type 2 diabetes and kidney disease. These vascular diseases all cause damage to blood vessels in the heart. Together they account for approximately one-quarter of the total disease burden in Australia and two-thirds of all deaths. It is important to realise that the burden of these conditions falls disproportionately on the poor, and particularly on groups such as Aboriginal and Torres Strait Islander peoples.

An integrated health check to assess patients' risk of conditions like heart attack and stroke would not only improve health but would lead to fewer hospital admissions and reduce prescribing for those not at high risk. Obviously, a chronic disease getting to the point where a hospital admission is required is an outcome that is bad for the patient and costly to the health system. An embedded, incentivised, integrated health check has the potential to greatly reduce hospital admissions and readmissions.

For example, the cumulative cost of treating all current and new cases of end-stage kidney disease from 2009 to 2020 is estimated to be approximately between $11.3 billion and $12.3 billion. If chronic kidney disease is detected early and managed appropriately then the otherwise inevitable deterioration in kidney function can be reduced by as much as 50 per cent. Likewise, there is strong research evidence that repeat cardiovascular events can be halved by effective secondary prevention care, including the use of medicines and lifestyle modification. Currently, one in four vascular patients will be readmitted to hospital, but it is estimated that up to half of these readmissions could be prevented through improved management in the primary care sector.

The second area where an integrated health check could help is that of unnecessary prescriptions for medication. The check could help ensure that only those who really need vascular medications, such as statins for lowering high blood cholesterol, will be prescribed to them. For example, some individuals may have isolated risk factors such as high blood pressure, but when their entire risk factor profile is assessed they may not be at high absolute risk and medication may not be necessary. Avoiding patients taking medications they do not really need is good for them, and it is a cost saving to the health system.

At its core, an integrated health check is about better outcomes for patients, it is about a more efficient health system and it is about quality improvements in care. It is to make sure we are spending taxpayers' money wisely to get the best health outcomes. This is an idea that has come up from the National Vascular Disease Prevention Alliance. I have been encouraged by the reception that the idea has received so far. The integrated health check is under consideration by the recently established Primary Health Care Advisory Group, which is chaired by Dr Steve Hambleton, and the department are also currently looking at it in terms of their proposed quality focused practice incentive payment. The House of Representatives Standing Committee on Health, chaired by my good friend the member for Swan, is currently undertaking an inquiry into chronic disease prevention and management in primary health care, with bipartisan support, and I am hopeful that the potential value of integrated health checks will be reflected in the findings of that inquiry.

I would like to pay tribute to the work done by the National Vascular Disease Prevention Alliance on this program. This alliance consists of the four groups—Diabetes Australia, Kidney Health Australia, the Heart Foundation and the Stroke Foundation—who represent the diseases which, combined, are the biggest killers of Australians. I encourage all members to look at integrated health checks as a positive improvement for our health system.