House of Assembly: Thursday, October 25, 2007

Contents

MEN'S HEALTH

The Hon. R.B. SUCH (Fisher) (11:31): I move:

That this house urges the Minister for Health to release the government's men's health policy as soon as possible.

As members know, I have had a longstanding interest in both men's and women's health. Fortunately, we have moved from the unproductive era when some people felt that if they supported men's health they were against women's health. Nothing could be further from the truth. In fact, if one looks thoroughly at both aspects, one sees the two are intertwined. A lot of women who are living alone wish their husband or partner was still with them, their partner having died as a result of illness or disease.

In 1992, when I was a member of the Liberal Party and a shadow minister, I argued for the incorporation in the 1993 election policy material for a commitment by the Liberal Party on men's health. The then shadow minister for health (Dr Michael Armitage) would not agree to it on the grounds that 'people will laugh'. Well, people do not laugh when they get a serious illness, particularly if it is a cancer.

I commend the Minister for Health (who is very supportive) and the former minister for health (Hon. Lea Stevens), who was an excellent minister—they are very progressive in relation to men's health—and also, the Hon. Dean Brown who preceded the Hon. Lea Stevens. Recently, there has been a change in attitude amongst ministers for health; and I am pleased to see that.

People might ask why we need to focus on men's health and have a health policy. It gives a focus to government and the community and shows that governments are taking this issue seriously. Recently, I was having a tidy-up in the office and I found a copy of a women's health policy released in 1988 by Dr Neal Blewett, a member of the House of Representatives and a federal minister at the time. It shows the length of time we have been focused on women's health—and so we should.

The case for a men's health policy is very compelling if one looks at the statistics. Recently, I had the privilege of attending the launch of the Freemasons Foundation Centre for Men's Health, based at the University of Adelaide. It is supported by a range of organisations, including Andrology Australia, Australian Prostate Cancer Collaboration, Flinders University of South Australia, Hansen Institute, Institute for Medical and Veterinary Science, Research Centre for Reproductive Health, Royal Adelaide Hospital, SA Department of Health and University of South Australia. It is a wonderful initiative by the Freemasons and they should be commended for their generous support.

Information obtained from the Florey Centre (supported by a grant from the Australian Prostate Cancer Collaboration) found that amongst men aged 35 to 80 years, 47 per cent were overweight; 31.5 per cent were obese; 61 per cent did not get sufficient exercise; 44 per cent were sedentary; 33 per cent have been diagnosed with high cholesterol and a further 14 per cent qualified for diagnosis upon clinical examination; 9.5 per cent have been diagnosed with diabetes and a further 4.4 per cent qualified for diagnosis at clinical examination; 30.2 per cent have been diagnosed with high blood pressure and a further 29 per cent qualified for diagnosis at clinical examination; 12.5 per cent have been diagnosed with depression and a further 6 per cent met the criteria for diagnosis upon response to the depression inventory; 9.3 per cent have been diagnosed with anxiety; 11 per cent have been diagnosed with insomnia; and 57.2 per cent reported at least some degree of erectile dysfunction. They are concerning statistics.

Better Health, a publication of the Victorian government, took some statistics from the Australian Bureau of Statistics—Mortality Atlas December 2002 that show the death rate from many illnesses and diseases is generally higher for men than women. It published the average death rate per 100,000 persons, comparing males and females, as follows: malignant tumours (cancerous) 237.8 males compared to 146.7 females; ischemic heart disease, 190 males compared to 119.9 females; cerebrovascular disease (strokes), 65.9 males compared to 65.8 females; chronic lower respiratory diseases (lung problems), 46.6 per cent for males compared to 23.2 per cent for females; accidents, 35.6 per cent for males compared to 17.7 per cent for females; suicide, 21.9 per cent for males compared to 5.5 per cent for females; diabetes mellitus, 18.8 per cent for males compared to 13.6 per cent for females; influenza and pneumonia, 13.6 per cent for males compared to 11.4 per cent for females; motor vehicle traffic accidents, 13.1 per cent for males compared to 5.5 per cent for females; and mental disorders, including dementia, 9.3 per cent for males compared to 10.8 per cent for females.

If you look at the statistics, men are not travelling well in terms of their health, and it is therefore important that we focus on some of those issues. If you look specifically at prostate cancer (of which I have had some involvement—involuntary), each year in Australia more than 3,000 men die of prostate cancer, which is equal to the number of women who die from breast cancer annually. Also, 18,700 new cases of prostate cancer are diagnosed in Australia every year. Each day 32 men will be told that they have prostate cancer and one every three hours will die from that insidious disease.

The ratio is that in your lifetime one in nine men will develop prostate cancer. It is the most common cancer in men and the second most common cause of cancer deaths in men. One could go on in terms of the statistics. One statistic which I think is particularly revealing (and it does not diminish the significance of violence against women) appears in an article by Michael Woods, a senior lecturer at the School of Biomedical and Health Sciences at the University of Western Sydney. Writing in the magazine Foundation 49 (the '49' referring to the men who make up 49 per cent of the population), he said:

In 2005 more than twice the number of adult victims of physical or threatened violence were men rather than women, and over a third of all victims of sexual assault were males.

He goes on to point out that (and this is based on statistics from the New South Wales Bureau of Crime) 28.9 per cent of victims of domestic violence in New South Wales are male. He makes the case that the rape of an 18 year old man should be no less a tragedy than the rape of an 18 year old woman. His article states:

The bashing of a young man walking home from work should be as much anathema as the bashing of a young woman in a nightclub. It is time that services recognised the extent of the problem and their obligation to assist male victims of violence.

Of course, in the main, that violence is caused by other men, so that needs to be borne in mind. However, it does not negate the basic thrust of the issue that we have a very serious problem in relation to men's health in Australia and, obviously, that includes South Australia. Sadly a few years ago, someone who lived not that far away from me took his own life when he was diagnosed with prostate cancer. He took his own life on the road by deliberately driving into an oncoming truck, which is sad, and sad for truck driver as well.

He had been going to his local GP for years, getting his blood pressure checked and supposedly having check-ups, but not once did the GP ever check for prostate issues. After he took his life, the widow of that chap really gave that doctor a blast and said, 'You were supposed to be checking my husband's health. Never once did you check for prostate problems.' By the time he was diagnosed it was basically too late. The point is that many men do not go to their doctor for a prostate check or other checks.

An interesting study based in the UK (the details of which were released recently) asked men, 'Why don't you go to the doctor?' The answer was, 'Well, I don't want to go to the doctor for a check-up because I'm not really crook. I might be getting in the way of someone who really needs that help.' That is a bit of a different spin to the usual one that men are stupid, stubborn and do not want to see the doctor. The general male view has been, 'I don't need to go to the doctor because there's nothing wrong with me, and I don't want to take the place of someone who is really sick.' That is not very helpful in terms of early diagnosis and screening, because the lesson is that as soon as you get onto some of these major issues and deal with them the better.

Probably the only reason I am still around is that I have taken an interest in these issues for a long time. My GP is of a similar mindset and was quite keen that I be regularly checked. The issue in terms of having a men's health policy is not simply to have a piece of paper—a lot of issues need to be addressed. Men living in rural Australia are the people suffering the most because they have little access to services, especially specialist services. They lack awareness. The macho-type culture, which is even stronger in the country than the city, does not help; and men generally do not go to doctors because, as far as I know, not many of them have babies and not many of them want to.

They do not have the same physiological conditions that women have to deal with, such as menopause, menstruation and so forth. Men generally do not front the doctor as often as women do. We need to change that mindset and get men to have regular check-ups, and not just for prostate cancer. Many men do not like the idea of a digital rectal examination, but my argument is that it would be preferable to have that rather than to have prostate cancer. That in itself is a very basic test. You can then have the blood test (the prostate specific antigen test), which is an indicator, a snapshot in time. If you really want to know you then have a biopsy, which nowadays, fortunately, is painless.

There is a long way to go. We have good organisations, and I mentioned before the Prostate Cancer Foundation of Australia. We now have the Freemason's centre here and we have Andrology Australia, which is based at the Monash Institute of Medical Research. Men are suffering, for example, from things such as testicular cancer, and there is not even a support group for those young men or men of any age who suffer from that. As far as I am aware, there is no support group for the partners of men who have prostate cancer. There is for women who have breast cancer, and that is fantastic, but the men are dragging the chain in terms of attention focused on things such as support.

I recently wrote to Kevin Rudd, John Howard and also Mark Vaile—to Mark Vaile, particularly, in relation to the needs of rural men and their health, asking what he is doing about helping country men get adequate information and treatment. Likewise, I wrote to Kevin Rudd and John Howard and asked, 'Where is your men's health policy?' It should be out there for the 49 per cent of the population who happen to be men.

The Minister for Health here (Hon. John Hill) I know has a health policy for men that he has had people working on for some time, and I expect he will release it either later this year or early next year. To his credit, his department has supported things such as a research project into men's use of health services in South Australia, improving men's participation in primary health care, improving men's access to primary health care, and a violence intervention training package involving men; and his department was the principal sponsor of the recent national men's health conference here in Adelaide.

So, I commend the minister for what he is doing. However, it is not just up to him; it is up to men to get active and do more, not only for themselves but also for other men, and take away the shield of ignorance. There would be a lot of older men who would not even know they have a prostate, and anyone over the age of 40 years whose relatives have had prostate cancer should be checked, and anyone over 50 years should have regular checks, anyway, irrespective of whether a relative has had it.

So, I ask the minister to expedite the release of the policy. I commend him on what he has done thus far, and appreciate his commitment (and that of the previous ministers for health, Lea Stevens and Dean Brown). I commend the motion to the house.

Debate adjourned on motion of Mrs Geraghty.