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House of Assembly - Fifty-First Parliament, Third Session (51-3)
2008-09-25 Daily Xml
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PREVENTATIVE HEALTH

The Hon. R.B. SUCH (Fisher) (11:55): I move:

That this house calls on the state government to increase its commitment to preventative health measures.

In moving this motion, I was very careful to include the wording 'increase its commitment', because I am not saying that the state government is not committed to preventative health measures or is not doing things which will assist in improving the health of the community: it is. What I am saying, and it is a legitimate point to make in here, is that I would like the government to do even more. As I said, that is not a criticism of what it is doing; it is really just saying, 'Let us see if the government can improve on what it is doing.'

Some of the things in which the government has been involved and to which it is committed—for example, improving the eating habits of children in schools—are worthwhile measures. I suppose a cynic may ask what it will achieve, if the children come out of school and then go to the local fish and chip shop and hoe into hot chips. Well, nothing anyone can do in terms of preventative health measures will ever be 100 per cent perfect, because unfortunately we do not live in a perfect world. However, it is a step in the right direction.

Some of my local primary schools have their children growing vegetables, because if you conduct a survey of children (which has been done by various groups) you would find that many children do not know the names of vegetables and cannot identify them. Indeed, it is just as well that the major supermarkets train their checkout staff to identify vegetables because many of the young people who work there part-time have admitted to me that they had no idea what some of the vegetables were before the supermarket trained them.

It is an unfortunate situation when we have young people who probably would not know spinach if they fell over it. We ate it as kids because we did not have a lot of money, and it was one of the things we grew out in the backyard. However, awareness and knowledge about what to eat, as well as eating certain fruits and vegetables, is an important part of a preventative health program. Obviously some of those things are long term, but more schools should be involved in getting children to grow vegetables at their school. The ERD Committee recently visited the Blue Mountains council in New South Wales, which gives every family in its area what I think they call a 'mini garden'; it is a box of herbs and so on to encourage people to eat healthy foods. The council actually supplies that in the Blue Mountains.

A lot of other things need to happen in relation to preventative health. One aspect is that I believe most schools are not doing enough in terms of providing regular physical activity. Years ago primary school teachers themselves would run a physical education program; it was integrated into the school day. Then some teachers seemed to get a bit lazy and did not want to change into a tracksuit, or perhaps they did not want to get sweaty and come back into a classroom, so that approach to inbuilt physical activity in the school gradually weakened in some schools. It is not simply about playing sport on a Saturday: it is about integrating physical activity into the daily activity at school, and it should be absolutely mandatory that schools do that at every level. There should be regular integrated physical activity as part of the school curriculum; it should not be an optional provision, but a mandated requirement.

I have also been trying to encourage the state government with regard to manufacturers of so-called 'fast foods'. Incidentally, 'fast food' has generated a reactive movement called the 'slow food movement', which was a bit confusing to someone who is very keen on cooking because I took 'slow food' to mean cooking all day in a pot (a great way to cook a meal if you have the time). What they mean is an alternative to hamburger, french fries, and all that sort of thing.

One of the things that those companies could do is reduce the amount of salt, sugar and fat in some of those fast foods. Later on (hopefully, this morning) we will be talking about food labelling laws. People do not know what is in a lot of the fast foods they eat. If you ask companies like McDonald's and Hungry Jack's, they will tell you what is in the food, but you should not have to ring them up or send them an email to find out what is in the hamburger: it should be displayed in the fast food area so that people can, at least if they want to, understand what they are eating.

Many of those companies are now offering healthier alternatives. I am not a health food Nazi who says that you should never eat those sorts of things but it is a question of getting it into proportion and balance, and that is where the government needs to step up its awareness and information programs to ensure that people better understand.

Likewise, in terms of health, many people suffering from high blood pressure (hypertension) would not even know about it. How would they know, if they do not go and have a regular check-up? One of life's great ironies is that we get our vehicles checked and serviced but we do not necessarily do the same for ourselves or, within a family, ensure that every member of the family is having a regular medical check-up. The servicing might be a little different from that involving a motor car but the principle is the same.

Likewise, a lot of people have diabetes but are not aware of it. Undetected diabetes is very harmful and does long-term damage. Likewise, undetected high blood pressure can do a lot of damage to kidneys, eyes, and so on.

What are we doing in relation to screening children in schools, for example, as previously happened? That is something the state government could do and follow the example of the Scandinavian countries. I do not have a problem with children of various ages in schools, including secondary schools, being checked out physically, as well as being tested for learning disabilities and checking for psychological factors. I have previously mentioned that some of our more notorious murderers—and these are extreme examples like Worrell (the Truro murderer)—were known by the teacher in junior primary to have problems but they were not picked up professionally or dealt with professionally.

If children in schools are screened for physical aspects—I know someone who cannot have children because, as a boy, his testes did not descend and he is sterile—something like that would be picked up immediately by a qualified nurse or medical practitioner. Deafness would be picked up. People might think that parents should pick up deafness but I can tell you that that is not always the case and I know some parents (who were professionals) who did not pick it up. The deafness, at the level the student suffered from it, was picked up at primary school during the screening which used to occur but which does not seem to occur now. That is one area where the state government could intervene.

Some people might say, 'Let them go to their local doctor.' That is wishful thinking, because many people do not go to a GP for regular check-ups, and certainly not necessarily for their children. So people are allowed to get through the system and, in the long term, that omission is going to cost not only them personally in health ways, but also the taxpayer as an enormous burden in the future as we try to deal with these medical issues down the track.

Professor Graeme Hugo (professor of geography and demography at Adelaide University) said a week or two ago that, when the baby boomer population really hits the hospital demand era, then look out, because the costs are going to be enormous if we do not get a handle (and that means the government does not get a handle) on preventative health.

We do not need all these people going to hospital. When I look around, I see people, even in this parliament, who smoke. I say to them, 'Look, it's an awful way to die, if you get emphysema, to drown in your own fluid.' It is a terrible way to die, and that is apart from the other things, such as cancer of the mouth, having bits of your tongue cut out. It is an awful thing. I say to these people, 'We want you to be around, irrespective of your political affiliation,' and they say that their father lived to be so and so, and that is just a silly answer. People need to get real. The minister acknowledged the other day in a chat: how do you make people do things that will help them in terms of their health? Well, you cannot make them, but I do not think the government should make any apology for going in hard on some of these issues.

In the workplace, progressive councils, such as Onkaparinga and Marion, have in situ workplace health checks, not just for blood pressure but they also check for skin cancer. They also help people who have stress. They do a lot of fantastic things like that, and so does the ANZ Bank. The state government could also be doing it through the Public Service. We should be doing it in this parliament, too, making it available to members and staff. If you can pick up some of these things early on, you can often deal with them effectively. It is not simply physical health: it is mental and psychological health as well. So, with councils like Marion and the City of Onkaparinga, if someone has a family-related stress issue, they get that person the assistance that is required.

The state government runs a fantastic breast cancer screening program, yet 30 per cent of women in the target group do not bother to avail themselves of that program. A lot of men do not get checked out for prostate cancer. If anyone has a male family member who has had prostate cancer they should be getting screened from the age of 40; and, for anyone else, certainly from the age of 50. One area I hope all members in this place would focus on is that, at the moment, country people are disadvantaged in terms of health provision. They do not have access readily to doctors and specialists, and that is particularly true, but not exclusively true, of country men. They are in the category, along with indigenous people, of having the worst health in the country.

Then you come to the lower socioeconomic categories and find that, in our suburbs where we have low socioeconomic categorisation, the level of their health standards is appalling. We cannot and should not sit back and allow that to continue. I know the minister is personally committed to doing something about that and is helping to fund information gathering but, more importantly, action to deal with that poor health profile that exists in some of our poorer suburbs and certainly amongst country people and indigenous people.

The information about things like prostate cancer—and it is the same with any cancer—is to get it early and, if you can get rid of it quickly, you are halfway on the road to recovery. If you leave it too long, you will often pay a very severe price.

There are some people who say that screening for prostate cancer is not cost effective. Well, it is if you are the person who is saved from an awful death. I think we will find in time that there will be increasing commitment to earlier screening for men on a widespread basis to detect prostate cancer. To that end I am pleased that the state government now has a men's health strategy. It is not perfect, but it is a start. It has come a long way since the time when we did not have one in this state. The federal minister, to her credit, has a men's health policy in operation, so some progress is being made.

Some other things that can be done are: improved areas for exercise, walkways and cycleways. All those things are part of a total package of preventative health. What I am saying is that I would like to see the state government increase its commitment. It is already committed, but let us really lead the world.

Time expired.

Ms SIMMONS (Morialta) (12:10): I move to amend the motion as follows:

Delete all words after 'government' and insert: 'to continue supporting preventative health measures.'

Keeping people out of hospital by promoting healthier lifestyles is actually the central part of the South Australian Health Care Plan 2007-2016. We cannot emphasise more how important we think this issue is, or be more committed to ensuring that South Australians take responsibility for making their own good health a focus and priority. At the heart of the South Australian Health Care Plan is the wellbeing and healthiness of all South Australians.

We know that healthier lifestyles can reduce chronic diseases and, hence, the need for health services. Prevention is always better than cure. We need to help our community make its own healthy choices, and I believe we are doing that. Yesterday, the Minister for Health announced that, following the launch of the state government's TV campaign urging people not to go to our emergency departments for minor ailments, there has been a drop of 7.1 per cent in presentations this winter.

People are choosing to go to their GP, GP Plus centre or use the very valuable Health Direct call centre to obtain advice on their medical condition before deciding how to proceed. The number of people choosing to get a flu vaccine hit record levels this year, and flu cases in South Australia dropped to 89 cases, compared to 431 cases for the same period in 2007.

SA Health has significantly increased its investment in prevention programs as part of its GP Plus health care strategy. In 2007-08, an additional $21 million was made available for primary health care, and this has increased to $35 million in the 2008-09 budget. This money funds a range of preventative, early intervention and clinical services in the community, often in people's own homes. This is very important for our older population, who may not be mobile enough to access programs out in the community.

These initiatives include a greater focus on supporting individuals to change their unhealthy lifestyles; for example, the Do it for Life program, which provides one-to-one coaching to individuals with extreme risk factors that put them at risk of developing a chronic illness, such as heart disease and diabetes. There are also new programs aimed at the broader community, encouraging them to eat well and increase their activity levels, as well as increased support to existing successful programs, such as those encouraging people to quit smoking.

I agree with the member for Fisher that this is one of the biggest drains on our health budget, and it is one to which we need to pay particular attention. Like him, I encourage our parliamentary colleagues who still indulge in smoking to think very carefully about what the end of their life may look like.

We are confident that this approach, which has often been undertaken with other key partners, such as schools, as part of the SA Strategic Plan, will improve the health and wellbeing of South Australians. As I said in my recent Address in Reply speech, this government is also committed to ensuring that children have a healthy start to life. We know that if they are not healthy they will not achieve their true potential.

According to disturbing South Australian data, 20 per cent of four year olds are overweight or obese. I am a member of the Social Development Committee of parliament that led an inquiry into this subject in 2007. The member for Fisher may well be cynical about the banning of certain foods in schools, if the children are then going out to the fish and chip shop afterwards, but this government believes that by putting a major focus on healthy eating and physical activity in schools we are fulfilling an important role in enabling students to develop their capacity for healthy growth and development into adulthood and, hence, healthier futures.

Members will be aware that we have announced that we are adapting the French EPODE program to local conditions. EPODE is a successful program run across more than 100 communities in France, Belgium and Spain, which has shown proven results in helping to combat obesity in children. We want to introduce the program here and bring communities across the state together with the common goal of fighting childhood obesity. The member for Fisher is quite correct in saying that we cannot leave this up to the children: it has to be a whole of community approach.

This initiative will involve the whole community, with leadership from local government and the active participation of health services, businesses, shops, workplaces and community organisations. Already some Adelaide councils have expressed interest in being part of the program.

The new program is in addition to other measures by the state government to combat childhood obesity including, as we have said, the banning of junk food in public school canteens; releasing a consultation paper flagging a ban on junk food advertisements on TV during children's viewing time (about which I personally feel very strongly, as did the Social Development Committee); working with preschools and schools to encourage children to swap soft drinks and junk food snacks for water and fruit; and introducing the Premier's be active Challenge (on the back of the Premier's Reading Challenge, we hope that this will be equally as successful). We have also introduced the Start Right Eat Right healthy food program in child-care services, with over 100 sites now accredited, and we have recruited 10 healthy weight coordinator positions across the state.

We are taking all these measures because we know that obesity, in addition to other new century illnesses in adults, continues to put huge pressure on the SA health system. This government has taken the advice of the Menadue Generational Health Review very seriously, we are taking urgent steps to refocus the culture of health care in this state. Our reform places an emphasis on preventative measures, lifestyle change and engaging members of the community in making healthy choices for themselves. I therefore commend the amended motion to the house.

Amendment carried; motion as amended carried.

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