Monique Ryan (Kooyong, Independent) Share this | Link to this | Hansard source

One in 20 Australians—that's 1.5 million people—lives with diabetes. That's a number which continues to increase. The nation faces a diabetes epidemic. Type 2 diabetes is by far the most common form in Australia. It's much more likely to affect people of lower socioeconomic standing—those people who have less access to clean water and to affordable fresh food, who have less time and space for regular physical activity and who often have less access to health care.

First Nations people have a frighteningly high incidence of type 2 diabetes. They develop it at a younger age, and their progression to potentially life-threatening complications is extraordinarily rapid. Diabetes is the leading contributor to the gap in life expectancy between Indigenous and non-Indigenous Australians. In fact, Aboriginal and Torres Strait Islander people are nearly five times more likely to be hospitalised for diabetes related complications. Diabetes is the leading cause of death for Aboriginal people in the Northern Territory. The reasons for this are complex. They include both genetic predisposition and a raft of socioeconomic factors. Those factors include the urgent need for action on diet.

All Australians eat too many ultraprocessed foods and too many foods with added sugar and hidden chemicals. Unhealthy foods represent a third of Australian children's diets; one in four is overweight or obese. For too long, obesity and type 2 diabetes have been understood in this country as conditions which are caused by personal choices, but our committee's findings found that it's a lot more complex than that.

Forty-one per cent of the total energy intake of Aboriginal and Torres Strait Islander people is derived from what we would usually call discretionary foods and drinks—items which are high in saturated fat, salt and sugar. This is not always an issue of choice. The health committee visited rural communities, and it was tragic to see, in this day and age and in this country, that tap water was unsafe and undrinkable and that bottled water cost more than Coke. We went to a community in which the only vegetable in the shop was potatoes—and they were $11 a kilogram—and in which the only fruit that was available was frozen. All of those foodstuffs cost two or three times what they would in a capital city. Parents have to feed their kids. They'll do what they have to, to keep their kids happy. It's up to all of us to ensure that all Australians have access to affordable healthy food choices and safe water.

It's also an issue for people in the capital cities as well. Most Australians don't understand how much sugar is added to our food. The regulation of food manufacturers in this country is poor, whether we're talking about codes for infant formulas or health-star ratings for other foods. Their labelling is remarkably misleading and makes it impossible for parents. Forty-three per cent of the foods for infants and toddlers in our supermarkets exceed the recommended limits for sugar, often because they contain processed fruit sugars in the form of fruit juices, pastes or purees. Many breastmilk substitutes, or what are being marketed to young mums as toddler milks, are effectively just sugary drinks.

Our labelling codes are voluntary, and only 41 per cent of products display health-star ratings. Manufacturers of healthy products use those health-star ratings as a marketing tool, and those that don't market healthy foods just don't put a health-star rating on the packaging. The star system is also problematic because it doesn't distinguish between natural sugars and artificial sweeteners. It gives higher ratings to ultraprocessed foods and lower ratings to whole foods. We urgently need a mandatory food-labelling scheme which provides accurate and clear health information to consumers when they buy food for themselves and for their families.

Australians also deserve access to universal, quality health care. People living with diabetes in this country often have to contend with very high prices and long waiting times when they're trying to access vital medical supports, which can help them with their insulin management and their weight management. The health committee has called on the government to fund longer MBS consultations, to support expanded telehealth services and to broaden case coordination models for people with diabetes and obesity. We have to change our model of care in the face of the increasing prevalence of complex and chronic diseases in an ageing Australian population.

We also recommended to the government that we subsidise access to evidence based pharmaceuticals, monitoring devices and bariatric surgeries for people who are living with diabetes and obesity. GLP-1 receptor agonists and similar medications are game changers for Indigenous persons and young adolescents with type 2 diabetes. It is terrifying to see the number of adolescents with type 2 diabetes in some communities, particularly Indigenous communities. When I was a paediatrician, there was no such thing. Now it's becoming a really common problem, and it's going to affect the next generation in a way that will bite home very significantly in decades to come. GLP-1 receptor agonists facilitate rapid weight loss and improve diabetes control, They have a significant effect on long-term complications like renal failure, diabetic neuropathy, premature heart disease and peripheral vascular disease. They also have significant side effects, and their cost is extremely challenging. We have a healthcare system that is already struggling to deal with approvals processes and with the cost of new and emerging medications and technologies.

A division having been called in the House of Representatives—

Sitting suspended from 12:11 to 13:03

Terry Young (Longman, Liberal National Party) Share this | Link to this | Hansard source

Before we begin in continuation with the member for Kooyong, there was an error before where you didn't ask for leave—as you've already spoken on this. If you can just ask for leave to speak on this, that will be fine.

Monique Ryan (Kooyong, Independent) Share this | Link to this | Hansard source

I ask leave of the chamber to speak again on this.

Leave granted.

We have to take action to prevent increasing intergenerational morbidity associated with diabetes. It is not overstating the case to say that the potential impact of this issue in the decades to come on population health but also on our economy is terrifying. We do not plan well enough for long-term, large-scale healthcare provision in this country. The lack of availability of bariatric surgery outside the private hospital system is a case in point.

It was a privilege to be a member of the parliamentary committee which investigated diabetes in Australia, but our efforts will be wasted if the government does not act on the committee's findings. Far too many government committee reports gather dust on shelves. It's not just a waste of the committee's time, effort and money. It's not just an insult to the hundreds of people who gave their time and the benefit of their experience in the undertaking of this committee. It's also the opportunity cost of not taking action on what is an emerging public health emergency in this country.

We need to take action in the simplest and most fundamental of ways. We need to improve regulation of the food and drinks industry in this country and we need to improve the provision of health care for complex and chronic diseases. If we do not, we will all bear the cost and the loss associated with the plague that the emerging diabetes epidemic represents.

Debate adjourned.

Sitting suspended from 13:05 to 16: 37